STDs (or sexually transmitted diseases) are infections that spread from person to person through sexual activity. Oral sex, anal sex and the sharing of sex toys can also spread STDs.

The most common STDs in the United States are: genital herpes, human papilloma virus (HPV), chlamydia, gonorrhea, and syphilis. The human immunodeficiency virus (HIV) is also spread through sex, and can lead to acquired immunodeficiency syndrome (AIDS).

You may have heard of some of these diseases. But did you know that:
•At first, many STDs cause no symptoms, especially in women?
•Symptoms of STDs can easily be confused with symptoms of diseases that are not STDs?
•STDs can still be passed to sexual partners even if a person does not show symptoms?
•Health problems caused by STDs tend to be worse for women than for men?

How do I know if I have an STD?

The signs depend on the type of STD. Some people with an STD have no symptoms at all.

You might have an STD if you have:
•sores on or near the genitals (and for women, in the vagina); the sores may hurt or be painless
•discharge from the penis
•vaginal discharge
•burning during urination
•pain during sexual intercourse

STDs can also cause fever, swollen glands, and lower abdominal pain.

Call your doctor right away if you notice a sore or an abnormal discharge. You should also call your doctor if your sex partner has had an STD, even if you seem fine. If you have used condoms carefully, it is still important to report these symptoms to your doctor. Condoms are not foolproof.

Don’t let embarrassment keep you from getting checked out. Untreated STDs can lead to serious health problems. It is important to know that symptoms of an STD (or proof that you have an STD) do not necessarily mean a partner has been unfaithful.

What will my doctor do?

Your doctor will ask you about your symptoms. He or she may ask how many sexual partners you have had and if any of them have had an STD. Your doctor will do tests based on your symptoms and history. The most common tests are:
•a thorough physical exam, with careful attention to the genital area; women should also have a pelvic exam—often the exam alone gives a good clue as to what (if any) STD you may have
•blood tests to look for an earlier herpes infection, syphilis, or HIV
•a urine test to help diagnose chlamydia
•tests on samples from any genital sores or ulcers, or abnormal genital discharge

If you have one STD, your doctor will likely suggest that you get tested for HIV and other STDs, because the risk factors are similar. Also, you are more likely to get HIV if you are infected with another STD.

Genital herpes

What is it and how does it spread?

The herpes virus causes blisters and skin ulcers in the genital area. Herpes spreads through skin-to-skin contact, including kissing.

Symptoms of genital herpes include:
•itching, burning, soreness, and small blisters in the genital area
•small ulcers (skin sores) after the blisters break
•pain if urine touches the sores
•swollen glands in the groin
•headache, fever, and generally feeling ill

Many people with herpes have no symptoms, so they don’t realize they carry the virus. An infected person often spreads the virus when the infection is active—that is, when you can seek the skin blisters or ulcers. But an infected person can pass along the virus even when there are no symptoms at all.

Treatment

The virus that causes genital herpes never completely goes away—the symptoms come and go. However, your doctor can prescribe medicine that can shorten the time you have to deal with the skin sores. You need to take the medicine as soon as you notice symptoms of an outbreak.

When symptoms develop for the first time, they occur about one week after contact with an infected person. About 40% of infected people never have a second outbreak. In others, however, symptoms return one or more times per year. For people who have repeated outbreaks, symptoms tend to occur after sexual intercourse, after sunbathing, and during times of physical or emotional stress.

If you have outbreaks a lot, your doctor may recommend that you take antiviral medicine daily. This may reduce the number of attacks by 80% in people who often experience severe episodes.

What else do I need to know about genital herpes?

Because the virus stays in the body for a lifetime it is possible to spread the virus even when you don’t have an active outbreak.

Pregnant women can pass herpes to their babies during birth. This is dangerous for the baby. If you are pregnant, tell your doctor if you have had genital herpes. With the right care, you can prevent giving the virus to your child.

The best way to prevent spreading herpes is not to have sex, even with a condom, when you have sores. And you or your partner should use a latex condom every time you have sex, even when you don’t have an active outbreak. While not 100% effective, condoms lower the chances that you will spread the virus.

Human papillomavirus (HPV)/Genital warts

What is it and how does it spread?

Human papillomaviruses (HPVs) cause warts. Certain types of HPVs cause warts on and near the genitals. Genital warts are small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. In some cases, warts can be so small that you can’t see them. Genital warts may cause itching, burning, tenderness, or pain, or may go entirely unnoticed.

Genital warts are spread through sexual intercourse. The virus can stay in the body for years, so warts may come and go. Because it takes time for the genital warts appear, you can have the infection for months and not know it. It is possible to pass the virus to your sexual partners even if your warts have gone away.

Treatment

Treatment depends on how big the warts are and where they are on the body. Your doctor can remove the warts by:
•applying a chemical solution to help dissolve the warts
•burning the warts off with a mild electric current
•applying liquid nitrogen to the warts to freeze the warts
•laser treatment or surgery (usually used for larger warts)

Never try to get rid of genital warts on your own by using over-the-counter products for warts on other parts of the body. Avoid having sex until treatment is finished.

What else do I need to know about HPV?

Using condoms may help prevent genital warts and HPV. However, condoms can’t cover all of the exposed skin. You are more likely get genital warts if you have:
•other STDs (because the risk factors are the same)
•multiple sex partners
•a weakened immune system

Women who have had genital warts should talk to their doctors about how often to have Pap tests to check for cervical cancer. The cells taken for your Pap test can also be checked for HPVs. HPVs are also linked with other cancers including anal, vaginal, vulvar, and penile cancers. HPVs spread during oral sex may cause throat cancer. Your doctor can help you take steps to detect and treat problems early. You should know that the types of HPVs that cause genital warts and related cancers are different from the HPVs that cause warts on other parts of the body.

The HPV vaccine

There are currently two vaccines that can help protect against HPV and HPV-related diseases. Two vaccines (Cervarix and Gardasil) have been shown to protect against most cervical cancers in women. One of these (Gardasil) also protects against genital warts and has been shown to protect against cancers of the anus, vagina, and vulva. Both vaccines are available for girls and women. Only Gardasil is approved for men and boys.

It takes three doses of the vaccine—before ever having any sexual activity—to get the best protection. That’s why expert recommend the HPV vaccine for preteen girls and boys at age 11 or 12 years.

HPV vaccines are recommended for all teen girls and women through age 26, who did not get all three doses of the vaccine when they were younger. It is also recommended for all teen boys and men through age 21, who did not get all three doses of the vaccine when they were younger. The vaccine is also recommended for gay and bisexual men (or any man who has sex with men) and men with compromised immune systems (including HIV) through age 26, if they did not get fully vaccinated when they were younger. All men may get the vaccine through age 26, and should ask their doctor if getting vaccinated is right for them.

*Adapted from the Centers for Disease Control and Prevention

Chlamydia

What is it and how does it spread?

Chlamydia is caused by bacteria and is spread during sexual contact. In many cases, this infection causes no symptoms, or symptoms that are easily mistaken for other minor problems. Often men and women with chlamydia don’t even realize they have it. When symptoms do occur, they include the following:

In women
•a burning sensation when urinating
•abnormal vaginal discharge
•light vaginal bleeding (especially after intercourse)
•lower abdominal (pelvic) pain

In men
•an abnormal discharge from the penis
•a burning sensation when urinating

Treatment

Antibiotics cure chlamydia. Treatment can usually prevent long-term problems.

What else do I need to know about chlamydia?

Untreated chlamydia can last for many months. During this time, bacteria can be spread to others through unprotected sex.

Without treatment, chlamydia can cause serious problems. In women, it can damage the reproductive organs which can lead to infertility (trouble getting pregnant). It also increases the chances of ectopic pregnancy (when a pregnancy grows outside the uterus). Pregnant women can also pass chlamydia to their babies during birth, which can cause eye infections and pneumonia in newborns.

If you are at risk for chlamydia, get tested at least once a year, even if you have no symptoms. Sexually active women at risk for chlamydia should have a routine pelvic examination with a chlamydia-screening test every year. Pregnant women at risk for chlamydia should also be tested, even if they have no symptoms.

Gonorrhea

What is it and how does it spread?

Gonorrhea is caused by bacteria. It is spread during sexual activity and can affect the cervix, vagina, and urethra (urine tube). This STD doesn’t always cause symptoms, and women tend to be symptom-free more often than men. When symptoms do occur they usually develop within two to 14 days after exposure and include:

In women
•pain or discomfort upon urination or frequent urination
•vaginal discharge
•discomfort in the anal or rectal area

Symptoms often occur around the time of a woman’s period. For some women, the bacteria move to the uterus and fallopian tubes, causing pain during intercourse, abdominal pain, abnormal bleeding, and fever.

In men
•a discharge from the urethra that may be clear or white, or thick, yellow, and puss like, which may stain underwear
•redness around the urethra, frequent urination and pain, or a burning discomfort during urination

Treatment

Gonorrhea infections rapidly improve with antibiotics. However, certain types of gonorrhea bacteria have become resistant to certain antibiotics. Sometimes one antibiotic doesn’t work and your doctor will need to try a different one.

What else do I need to know about gonorrhea?

Left untreated, gonorrhea can damage the reproductive organs. In some cases, this can cause problems getting pregnant.

Less commonly, untreated gonorrhea can spread to the bloodstream and infect other parts of the body, causing fever, a rash, and joint pain. In pregnant women with untreated gonorrhea, the baby may pick up the bacteria during birth. This can cause a severe eye infection in newborns that needs prompt treatment.

Syphilis

What is it and how does it spread?

Syphilis is caused by a type of bacteria. Syphilis can be transmitted by physical contact—usually sexual.

When left untreated, syphilis moves through a series of stages:
•Primary syphilis — A painless ulcer called a chancre develops, usually in the genital area where syphilis bacteria enter the body. This stage begins 10 to 90 days (on average three weeks) after a person has been exposed to someone with syphilis. The sore goes away without treatment in about four to eight weeks.
•Secondary syphilis — The bacteria spread and cause a rash over most of the body together with fever, aches and pains, and other symptoms. This stage begins six to eight weeks after a person is exposed, and it lasts up to one year.
•Latent syphilis — This stage begins when the secondary stage ends. Although there are no symptoms, the person remains infected. This stage can last for many years, even for the rest of a person’s life. About one-third of cases of latent syphilis progress to tertiary syphilis.
•Tertiary syphilis — Syphilis bacteria cause severe damage to many different internal organs, including the brain and spinal cord. It usually begins within 10 years of infection and can be fatal.

Treatment

With proper antibiotic treatment, early syphilis infections can be cured without causing permanent damage. Although later stages of syphilis also respond to treatment, antibiotics cannot repair organ damage caused by the disease.

What else do I need to know about syphilis?

Unless treated, syphilis is a lifelong illness. Pregnant women with syphilis can pass the bacteria to their babies, causing a condition known as congenital syphilis, which causes health problems in infants, and it can be deadly. If you have syphilis, it may be easier for you to become infected with HIV. And if you have HIV and syphilis, you are more likely to spread HIV to others.

HIV/AIDS

What is it and how does it spread?

HIV stands for “human immunodeficiency virus.” This virus weakens the body’s immune defenses by destroying CD4 cells, a type of white blood cells that protect against foreign invaders. Bacteria, viruses, and germs that normally cause mild illness now become severe problems. When the CD4 cells are depleted past a certain point a person can develop AIDS (acquired immunodeficiency syndrome).

Although HIV/AIDS is incurable, it is highly preventable. You can decrease your chances of getting HIV by avoiding high-risk behaviors, such as:
•unprotected sexual intercourse (heterosexual or homosexual)
•oral sex with an infected person
•a contaminated blood transfusion (rare in the United States since 1985, when blood supplies started being tested for HIV)
•needle sharing
•occupational exposure (accidental needle stick with infected blood)
•artificial insemination with infected semen
•organ transplant from an HIV-infected donor

There is no evidence that HIV can be spread through casual contact such as kissing; sharing food utensils, towels, or bedding; swimming in pools; using toilet seats; using telephones; or through mosquito or other insect bites.

Treatment

HIV cannot be cured, but it can be treated with a drug combination called highly active antiretroviral therapy (HAART). HAART medications must be taken every day for the rest of a person’s life. However, this drug combination has turned HIV from a fatal illness into a treatable, chronic disease.

What else do I need to know about HIV?

Although it is a scary think about having HIV, call your doctor right away if you think you may have been exposed this virus. A combination of HAART drugs can decrease your risk of getting HIV. These drugs work best when they are taken within three days of the exposure. Pregnant women with HIV, or at risk for it, should also talk with their doctors to learn about ways to prevent passing the virus to their babies.

What else should I know about STDs?

Most STDs respond well to treatment. However, in many people infections come back because their sex partners are not treated or because they have unprotected sex. All sex partners should be treated whenever any person has an STD. Most doctors urge patients to tell their sex partners if they have an STD so that those people can seek medical attention.

People who have an STD may be contacted by their local health department so that their sex partners can be evaluated and treated. This is done for two reasons. First, some STDs can be passed unnoticed between sex partners. Second, the fewer people who get and spread STDs the better for everyone’s health. Proper treatment means fewer people affected.

You can help to prevent STDs by:
•not having sex
•having sex only with one uninfected person
•consistently using male latex condoms during sexual activity

Remember, condoms can help reduce your exposure to STDs, but are not foolproof.