Untreated STDs cause 24,000 women to become infertile each year. When chlamydia and gonorrhea are left untreated, 10 to 15 percent of women will develop pelvic inflammatory disease (PID). PID is an infection that can cause permanent damage to the fallopian tubes and uterus, and lead to infertility. PID also can lead to ectopic (tubal) pregnancy, which can be life threatening if not promptly diagnosed and treated. Most women with chlamydia and gonorrhea have no symptoms of the STIs or PID, but still can have silent PID that can lead to infertility or ectopic pregnancy, making screening for these illnesses key.
Untreated STDs can lead to long-term health problems. For instance, untreated syphilis can cause blindness, paralysis, and other kinds of brain damage or even death. HPV can lead to cervical cancer, anal cancer, or penile cancer, and chlamydia and gonorrhea can cause infertility and ectopic pregnancy. Hepatitis B predisposes one to liver cancer. Although herpes and most HPV infections do not usually cause serious side effects, both can lead to severe anxiety, stress or other psychological disabilities due to their incurable nature and potential for transmission to other sex partners. To protect your health, it’s critical that you practice safe sex and get screened for STDs regularly if you have sex outside a mutually monogamous relationship or if you suspect your partner might be having sex with other people. In addition, if you are diagnosed with an STD, it’s important to take your medication as prescribed by your doctor to either cure or control the infection.
STDs cause serious health problems for women, pregnant or not, but certain STDs carry additional risks to both the pregnant mother and her child. Having an STD during pregnancy can result in premature labor or a uterine infection after birth.
In addition, if a mother is infected, some STDs can be passed to her baby either during pregnancy or childbirth. Babies born to mothers with STDs have a higher risk for low birth weight, infections, brain damage, deafness, blindness, and stillbirth. Taking antibiotics during pregnancy and childbirth can help prevent problems from bacterial STDs; viral infections like herpes or HIV can’t be cured, but can be treated, and preventative measures can significantly lower the health risks to a newborn. STD testing is often a routine part of prenatal screening, but not all doctors check for STDs if they don’t know a mother has been at risk. So it’s imperative that you make and keep all your doctor’s appointments while pregnant, and if you have ever been at risk — you’ve had multiple partners or sex with a partner at risk — you should request an STD screening.
Women get STDs more often than men and are more likely to have long-term health consequences than men. This is mostly due to the female anatomy. Women’s genital tissues are moist, thinner, and more susceptible to some infections than the skin on a man’s penis, making infection more likely. Also, the vagina retains a partner’s semen, prolonging exposure to viruses and bacteria that may have been deposited.
Woman are often less likely than men to have typical symptoms of common STDs, or to have mild symptoms that don’t seem different from normal discharge or minor genital irritation that many women feel from time to time. Even when symptoms are present, they can be harder for women to spot (a woman’s vagina is a lot less visible than a man’s penis), and can be easier to mistake for something else (like a yeast infection or normal vaginal discharge).
In teen girls, the cervix — the lower part of the uterus — can be especially susceptible to chlamydia and gonorrhea, which is partly why these STDs are especially common in the teen years. This makes it even more important for teenage girls to make sure they use condoms every time they have sex and to be frequently checked for STDs even when nothing seems wrong.
Ideally, all doctors would automatically test all sexually active younger women and men for STDs every time they get routine reproductive health care, such as Pap smears. But many do not, and it is wise for all women to request STD testing if they have had more than one sex partner or if there is any doubt about their partner’s sexual history or lifestyle.
Don’t assume that STD testing was done just because you had a Pap smear. Paps are a good way to check for cervical infection with HPV (human papillomavirus), some types of which cause cervical cancer. But a Pap smear itself is not a test for other STDs.
Aside from Pap smears, routine STD testing usually means testing the urine or a swab specimen for chlamydia and gonorrhea; blood tests for HIV and syphilis; and, in women, checking for vaginal infections. Sometimes a blood test for HSV is also wise, especially if there are symptoms that could indicate herpes or if you have been sexually exposed to an infected partner. It usually isn’t necessary to test for viral hepatitis unless there are special risks.
Of course testing for STDs should be done promptly whenever symptoms show up, such as new vaginal or penile discharge, or when there’s the appearance of new genital sores, irritation, or bumps that may indicate genital warts.
In the absence of symptoms, how often you need to be tested for STDs depends on several factors, including whether or not you’re sexually active, whether you have had more than one sex partner, and whether your partner might be having sex with other people. Your age also makes a difference. For most women, annual STD testing is sufficient, but testing also should be considered after sex with a new partner, especially if a condom wasn’t used. It’s important to be open about your sexual history with your doctor, so he or she can help to determine what tests are appropriate for you, and how often you should be screened.
Non-barrier contraceptive methods, such as birth control pills or the intrauterine device (IUD), won’t protect you from STDs. If you’re sexually active, the only way to protect against HIV and other STDs is to use condoms (male and/or female condoms depending on the type of sex you engage in) every time you have sex. If you’re in a new monogamous relationship, often it is wise to keep using condoms until you and your partner have tested negative for HIV and other STDs.
Although abstinence is the only guaranteed way to protect yourself from STDs, there are steps you can take if you’re sexually active to minimize your risk of contracting an STD. Choose your partners wisely. STDs are much less common when people get to know the person before moving on to sex; but they are especially common when people have sex on the first date or under other casual circumstances.
Of course one of the most effective ways to protect against STDs is to use condoms. A latex male or female condom is best. Viruses may have a higher chance of passing through condoms made with natural membranes, but any condom is far better than none, so don’t hesitate to use a natural membrane condom if it is the only option. Use a new condom every time you have sex.
Other ways to lower your risk of contracting an STD include: avoid having multiple sex partners or sharing needles; abstain from alcohol, drugs or anything that can impair your judgment during a sexual interaction; speak frankly with your partner about STDs; and get tested regularly.
There are very effective vaccines available that protect against two STDs. First off, everyone should be vaccinated against hepatitis B regardless of whether they consider themselves at risk for it or not.
And two vaccines are available to protect against HPV. One of them, Cervarix®, covers the two HPV types most likely to cause cancer. The other, Gardasil®, prevents the same two types, plus the two HPV types that cause almost all genital warts. A vaccine that covers 5 more HPV types (9 types total) likely will be available soon. The HPV vaccines are most effective when given before people become sexually active, and parents are urged to have their children vaccinated by age 13 or 14. But even if not given that early, all sexually active young people (under 26 years old) should be immunized with one of the HPV vaccines.
Medically reviewed by: H. Hunter Handsfield, MD
Published May 14, 2012.
Jenilee is a medical writer, health educator and triathlete based in Charlotte, NC.
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