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Sexually Transmitted Infections
Topic Overview
Aside from colds and the flu, sexually transmitted infections (STIs) are some of the most widespread infections both in the United States and the world. STIs affect both men and women, and almost half of all STIs occur in people younger than 25 years old. Exposure to an STI can occur any time you have sexual contact with anyone that involves the genitals, the mouth (oral), or the rectum (anal). Exposure is more likely if you have more than one sex partner or do not use condoms. Some STIs can be passed by nonsexual contact, such as by sharing needles or during the delivery of a baby or during breastfeeding. Sexually transmitted infections (STIs) are also called sexually transmitted diseases (STDs).
STIs are a worldwide public health concern because there is more opportunity for STIs to be spread as more people travel and engage in sexual activities. Some STIs have been linked to an increased risk of certain cancers and infection with human immunodeficiency virus (HIV). Pregnant women can spread STIs to their babies. Many people may not have symptoms of an STI but are still able to spread an infection. STI testing can help find problems early on so that treatment can begin if needed. It is important to practice safer sex with all partners, especially if you or they have high-risk sexual behaviors. See the Prevention section of this topic.
If you think you may have symptoms of an STI:
- Do not have sexual contact or activity while waiting for your appointment. This will prevent the spread of the infection.
- Women should not douche. Douching changes the normal balance of bacteria in the vagina. Douching may flush an infection up into your uterus or fallopian tubes and cause pelvic inflammatory disease (PID).
Common sexually transmitted infections
There are at least 20 different STIs. They can be caused by viruses, bacteria, and protozoa. Some of the most common STIs in the U.S. are:
- Chlamydia.
- Genital herpes.
- Genital warts or human papillomavirus (HPV). Certain high-risk types of HPV can cause cervical cancer in women.
- Gonorrhea.
- Hepatitis B.
- Syphilis.
- Trichomoniasis.
- Human immunodeficiency virus (HIV), which causes AIDS. Having other STIs, such as genital herpes, can increase your risk of HIV.
- Other infections that may be sexually transmitted. These include hepatitis A, cytomegalovirus, molluscum contagiosum, Mycoplasma genitalium, hepatitis C, and possibly bacterial vaginosis.
- Scabies and pubic lice, which can be spread by sexual contact.
Bacterial STIs can be treated and cured, but STIs caused by viruses usually cannot be cured. You can get a bacterial STI over and over again, even if it is one that you were treated for and cured of in the past.
Sexually active teens and young adults
Sexually active teenagers and young adults are at high risk for STIs because they have biological changes during the teen years that increase their risk for getting an STI and they may be more likely to:
- Have unprotected sex.
- Engage in high-risk sexual behaviors.
- Have partners who have high-risk sexual behaviors.
Studies show:
- Sexually active teens and young adults:
- Ages 15 to 24 years old get almost half of all new STIs each year.
- Have the highest rates of chlamydia and gonorrhea.
- Syphilis rates have increased the most in people ages 15 to 24.
- About 1 out of 5 women and 1 out of 9 men get genital herpes, and it is more common in women than in men.
- New HIV infections have increased in people ages 13 to 29.
It is important to seek treatment if you think you may have an STI or have been exposed to an STI. Most health departments, family planning clinics, and STI clinics provide confidential services for the diagnosis and treatment of STIs. Early treatment can cure a bacterial STI and prevent complications.
If you are a parent of a teenager, there are many resources available, such as your health professional or family planning clinics, to help you talk with your teen about safer sex, preventing STIs, and being evaluated and treated for STIs.
Risks specific to women with sexually transmitted infections
In women, STIs can cause a serious infection of the uterus and fallopian tubes (reproductive organs) called pelvic inflammatory disease (PID). PID may cause scar tissue that blocks the fallopian tubes, leading to infertility, ectopic pregnancy, pelvic abscess, or chronic pelvic pain.
STIs in pregnant women may cause problems such as:
- Miscarriage.
- Low birth weight.
- Premature delivery.
- Infections in their newborn baby, such as pneumonia, eye infections, or nervous system problems.
Risks specific to men with sexually transmitted infections
- Infection and inflammation of the epididymis, urethra, anus, and prostate
Any child or vulnerable adult with symptoms of an STI needs to be evaluated by a health professional to determine the cause and to assess for possible sexual abuse.
If you have symptoms of an STI or have been exposed to an STI whether by oral, anal, or vaginal sexual activity, check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
In females, symptoms of an STI (sexually transmitted infection) may include:
- New vaginal discharge.
- Pain or burning when urinating.
- Pain in the pelvis or lower belly. (Women may notice this during sex.)
- Itching, tingling, burning, or pain in the genital or anal area.
- Sores, lumps, blisters, rashes, or warts in the genital or anal area.
- Sores in the mouth or throat.
In males, symptoms of an STI (sexually transmitted infection) may include:
- Pain or burning when you urinate.
- New discharge from the penis.
- Sores, lumps, blisters, rashes, or warts in the genital or anal area.
- Pain, swelling, or tenderness in the scrotum.
- Sores in the mouth or throat.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don’t have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don’t have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Home Treatment
Home treatment is never an appropriate treatment for a sexually transmitted infection (STI). Evaluation by a health professional is needed for:
- Any changes or symptoms in the genital area that suggest an STI.
- A known or suspected exposure to an STI.
If you think you may have symptoms of an STI:
- Do not have sexual contact or activity while waiting for your appointment. This will prevent the spread of the infection.
- Women should not douche. Douching changes the normal balance of bacteria in the vagina. Douching may flush an infection up into your uterus or fallopian tubes and cause pelvic inflammatory disease (PID).
Symptoms of STIs may not appear for many days, weeks, months, or, with HIV, even years after an exposure. After you have been exposed to an STI, you cannot reduce the risk you now have of getting an infection.
A regular habit of genital self-examination once a month will help you know what is normal for you and when you may have symptoms of an STI.
In addition to your health professional, there are other resources that can help you with information about STI evaluation and treatment. These resources include:
- Local health departments that have STI clinics.
- Family planning clinics, such as Planned Parenthood (1-800-230-PLAN or 1-800-230-7526 or www.plannedparenthood.org).
- The U.S. Centers for Disease Control and Prevention STI hotline (1-800-CDC-INFO or 1-800-232-4636 or TTY: 1-888-232-6348 or www.cdc.gov/std).
Treatment for pregnant women is monitored by their health professional to avoid complications. STIs in pregnant women may cause problems such as:
- Miscarriage.
- Low birth weight.
- Premature delivery.
- Infections in their newborn baby, such as pneumonia, eye infections, or nervous system problems. These infections may threaten the life of your baby or cause serious long-term problems or disabilities.
It is important for you and an infected partner to complete all medical treatment for an STI to prevent the infection from returning. You may need to be rechecked after treatment is complete.
Symptoms to watch for
Call your doctor if symptoms persist or become more severe or frequent.
If you think you may have symptoms of an STI:
- Do not have sexual contact or activity while waiting for your appointment. This will prevent the spread of the infection.
- Women should not douche. Douching changes the normal balance of bacteria in the vagina. Douching may flush an infection up into your uterus or fallopian tubes and cause pelvic inflammatory disease (PID).
Home test kits for some STIs are available but it is recommended that you consult your health professional about any STI symptoms.
Prevention
You can take measures to reduce your risk of becoming infected with a sexually transmitted infection (STI). You can also reduce the risk of transmitting an STI to your sex partner.
Delay sexual activity until you are prepared both physically and emotionally to have sex. Nearly two-thirds of all STIs occur in people younger than 25 years old. Sexually active teenagers are at high risk for STIs because they frequently have unprotected sex and have multiple partners. Biological changes during the teen years also may increase their risk for getting an STI.
Make sure your immunizations are up-to-date. You can get a hepatitis A, hepatitis B, and HPV vaccine to prevent these infections. The HPV (human papillomavirus) vaccine protects against HPV. There are many types of HPV. Some types of the virus can cause genital warts. Other types can cause cervical or oral cancer and some uncommon cancers, such as vaginal and anal cancer. The HPV vaccine protects against the most common HPV types that can cause serious problems. For more information, see the topic Immunizations.
STIs are a concern worldwide. It is important to practice safer sex with all partners, especially if you or they may have high-risk sexual behaviors.
It is especially important that pregnant women who are at risk for STIs practice safer sex because an STI can affect their baby (fetus). An STI may threaten the life of your baby or cause serious long-term problems or disabilities for your baby.
Practice safer sex
Preventing a sexually transmitted infection (STI) is easier than treating an infection after it occurs.
- Talk with your partner about STIs before beginning a sexual relationship. Find out whether he or she is at risk for an STI. Remember that it is quite possible to be infected with an STI without knowing it. Some STIs, such as HIV, can take up to 6 months before they can be detected in the blood. Ask your partner the following questions.
- How many sex partners has he or she had?
- What high-risk behaviors does he or she have?
- Has he or she ever had an STI?
- Was it treated and cured?
- If the STI is not curable, what is the best way to protect yourself?
- Be responsible.
- Avoid sexual contact or activity if you have symptoms of an STI or are being treated for an STI.
- Avoid sexual contact or activity with anyone who has symptoms of an STI or who may have been exposed to an STI.
- Don’t have more than one sex partner at a time. Your risk of an STI increases if you have several sex partners at the same time.
- Some STIs can also be spread through oral-to-genital or genital-to-anal sexual contact.
- Abstain from sexual intercourse to prevent any exposure to STIs.
Condom use
Condoms can protect you against sexually transmitted infections (STIs). Even if you are protected against pregnancy by birth control pills or another method, use a condom to prevent STIs.
Male condom use
Using condoms reduces the risk of becoming infected with most STIs, especially if the condoms are used correctly and consistently. Condoms must be put on before beginning any sexual contact or activity. Use condoms with a new partner until you are certain he or she does not have an STI.
Condoms are made of latex (rubber), polyurethane, or sheep intestine. Latex and polyurethane condoms help prevent the spread of sexually transmitted infections (STIs) such as HIV, but sheep intestine condoms do not.
- Use a water-based lubricant such as K-Y Jelly to help prevent tearing of the skin if there is a lack of lubrication with condom use during sexual intercourse. Small tears in the vagina during vaginal sex or in the rectum during anal sex allow STIs to get into your blood.
- Do not use petroleum jelly as a lubricant with condoms, because it dissolves the latex in condoms.
- Use a male condom for vaginal or anal sex.
Female condom use
Even if you are using another birth control method to prevent pregnancy, you may wish to use condoms to reduce your risk of getting an STI. Female condoms are available for women whose partners do not have or will not use a male condom.
Condoms do not prevent skin-to-sore contact in the genital area, so it is possible to spread an STI with genital contact. It is important to have any symptoms in the genital area evaluated.
Mouth barriers, such as a dental dam, can be used to reduce the spread of infection through oral sexual activity. You can discuss this with your dentist or health professional.
Avoid douching if you are a woman, because it can change the normal balance of organisms in the vagina and increases the risk of getting an STI.
Spermicide use
Most spermicides contain a chemical called nonoxynol-9 (N9). The U.S. Food and Drug Administration (FDA) warns that N9 in vaginal contraceptives and spermicides may irritate the lining of the vagina or rectum. This may increase the risk of getting HIV from an infected partner.
So although using a spermicide with a condom is more effective for birth control, using a spermicide may increase your risk for getting HIV.
Preparing For Your Appointment
To prepare for your appointment, see the topicMaking the Most of Your Appointment.
You can help your health professional diagnose and treat your condition by being prepared for your appointment.
Before your appointment
- Do not have sexual contact or activity while waiting for your appointment. This will reduce the risk of transmitting the infection to your partner. If you do have an STI, your sex partner or partners must also be treated as soon as possible.
- Women should not douche. Douching changes the normal balance of bacteria in the vagina. Douching may flush an STI up into your uterus or fallopian tubes and cause pelvic inflammatory disease (PID). PID is usually caused by gonorrhea or chlamydia. Symptoms include pain in the lower abdomen and fever. PID may cause infertility, ectopic pregnancy, a pelvic abscess, or chronic pelvic pain.
Questions to prepare for your health professional
- If you have new STI symptoms:
- What was the date of your suspected exposure to an STI?
- Which STI do you think you were exposed to?
- How do you know?
- Did your partner tell you?
- What were your partner’s symptoms?
- Was your partner treated? If so, when? Was your partner checked after completing treatment?
- If you are a woman, what was the date of your last menstrual period?
- What are your symptoms? If you have discharge from the vagina or penis, it is important to note any smell or color.
- What method of birth control do you use?
- Which high-risk sexual behaviors do you or your partner engage in?
- If this is a repeat visit for exposure to STIs:
- Which STI have you had in the past?
- How was it treated?
- Did you complete the treatment?
- Did you get rechecked?
- Was your partner treated and rechecked?
- What has changed since your last visit?
- Have you had sexual contact with a sex worker? If so, when? Was a condom used?
- Do you have any health risks?
What you need to know by the end of the visit
- Is a test, such as a culture, being performed? How and when will you get the results of the test?
- Is there a diagnosis or do you need to wait for a test result? What does your health professional suspect?
- What treatment is your health professional prescribing? Be sure to get a written copy of treatment instructions and follow those instructions. Take all medicines exactly as instructed and for the full course of treatment. Do not stop taking your medicine even if your symptoms improve or go away.
- If you have an STI, who needs to be notified—your partner or partners, the health department?
- Does your partner or partners need to be treated at the same time?
- Do you need to stop having sexual contact or activity (abstain) during treatment, or are condoms appropriate to use during treatment?
- Will you need to be seen or treated again?
- Discuss STI prevention options.
- For women who are breastfeeding, discuss the risk of medicines being transmitted in breast milk.
Current as of: June 26, 2019
Author: Healthwise Staff
Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & Kathleen Romito MD – Family Medicine & Adam Husney MD – Family Medicine
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