The most common STDs that affect women are, in order of prevalence, HPV (which causes genital warts), Gonorrhea, Chlamydia, Herpes, Trichomoniasis, pubic lice, scabies (ectoparasitic infections)HIV/AIDS. We’ll describe the symptoms, diagnosis, and treatment for each of these and more below.
Human Papillomavirus (HPV) and Genital Warts
HPV is the most common STD in US women. According to the Centers for Disease Control and Prevention, HPV is so widespread that nearly every sexually active person will contract HPV at some point in their lives if unvaccinated against it. There are many types of HPV, which can be contracted through vaginal, anal, and oral sex, or skin-to skin-contact. Many strains of HPV do not cause symptoms and will resolve on their own, but some strains can cause warts on the genitals, mouth, or throat. Other signs of HPV include genital lesions, which can be painless or cause itching, burning, or tenderness, and can cause abnormal Pap Smears.
Several HPV strains can lead to cervical cancer. A Pap smear is a screening test that can help diagnose cervical cancers. There is no cure for HPV infection, but treatment involves monitoring for cervical abnormalities and removal of suspicious lesions. Men and women between the ages of 11 and 45 can be vaccinated against certain strains of HPV, specifically the ones known to cause genital warts and cervical cancers.
Gonorrhea
Gonorrhea is a common bacterial STD. Most people infected with gonorrhea will not experience any symptoms. Those who do have symptoms may notice: unusual genital redness, swelling, or discharge, vaginal itching or burning, and painful urination. If untreated, gonorrhea can lead to infection in the pelvis (in women) and throughout the body, so it’s important for sexually active people to be tested for this disease. To test for gonorrhea, a medical professional will look for bacteria by swabbing the rectum, throat, or cervix, or a urine test can be performed. Gonorrhea is treated with antibiotics.
Chlamydia
Gonorrhea and chlamydia frequently occur together, and like gonorrhea, chlamydia is bacterial and one of the most commonly reported STDs in the U.S. It's spread mostly by vaginal or anal sex, but can be transmitted through oral sex as well. Symptoms are similar to gonorrhea, such as genital redness, swelling, or discharge, vaginal itching or burning, and painful urination. However, most people with chlamydia don’t know they have it – only about 25% of women and 50% of men experience symptoms. Chlamydia is diagnosed through a cervical swab or urine test in women, and a urine test or urethral swab in men. It is treated with antibiotics.
Syphilis
Syphilis is another bacterial STD. It’s symptoms occur in four stages.
- A painless sore (called an ulcer or chancre) appears that can look like a cut or an ingrown hair. You are most contagious when this is present.
- A rash on your body. Typically, the rash presents on the palms of your hands or soles of your feet, and does not itch or hurt. This stage can also include hair loss, sore throat, fever, headaches, and white patches in the nose, mouth, and vagina.
- Sores and rashes usually disappear in the third, or latent, stage. This stage can last years. In this stage, syphilis is not contagious.
- Only about 15% of people with untreated syphilis will develop the final stage. This stage of syphilis can be fatal as it causes serious issues in different organs like the heart, brain, eyes, ears, and nervous and muscular systems. Some symptoms of this tertiary stage include dementia, vision problems or blindness, trouble controlling muscular movements, and numbness in various parts of the body.
Syphilis can be diagnosed through blood tests, or by evaluating or testing ulcers from the first stage. Syphilis is effectively treated with antibiotics .
Genital and Oral Herpes
Genital herpes is also common, about 1 out of 6 Americans have it. There are two types of herpes - herpes simplex virus-1 (HSV-1), which usually causes sores around the mouth, and herpes simplex virus-2 (HSV-2), which usually causes blisters around the genitals and anus. Herpes is highly contagious through skin-to-skin contact, and easiest to catch when blisters are present.
The main sign of herpes is the lesions, which can hurt or itch. Diagnosis is made by observing the lesions, testing the fluid inside them, or taking a blood test. Because herpes is a virus, medicine can’t cure it, but there are some medications to help manage the symptoms and duration of the outbreak. It’s important to note that herpes can spread from one part of the body to another, so avoid touching the blisters and then another body part, especially the eyes or mouth, and wash your hands right away if they come in contact with a herpes sore.
Trichomoniasis
A parasite causes trichomoniasis, which is transmissible through genital contact. More women than men become infected, though most don’t experience symptoms. The 30% who do have symptoms may notice burning, itching, sore genitals, or smelly, clear, white, yellowish, or greenish discharge. Trichomoniasis is diagnosed through a urine test or vaginal swab, and can be treated with antibiotics.
Pubic Lice and Scabies (ectoparasitic infections)
Ectoparasitic infections are caused by tiny insects, such as lice or mites, that feed off their hosts. They are transmitted by physical contact, and their main symptom is itching. Pubic lice (pediculosis pubis) is caused by the crab louse, Phthirus pubis, commonly referred to as crabs. The lice live on pubic hair and are visible to the naked eye. You can treat pubic lice with a cream rinse containing 1% permethrin, or pyrethrins with piperonyl butoxide, applied to the affected area. Scabies is another ectoparasitic infection caused by the mite Sarcoptes scabiei. These mites can’t be seen with the naked eye, and live on the skin. They cause itching on the genitals and body, which can be accompanied by small bumps. The itching usually starts several weeks after infection, and tends to worsen at night. For treatment, a 5% cream of permethrin is applied to the entire body for 8 to 14 hours, washed off, and applied again one week later. An oral drug, Ivermectin (Stromectol), can also treat scabies, but carries more risk of side effects than the cream. With both lice and scabies, treatment should include a thorough, hot washing of all bedding and clothes.
HIV/AIDS
HIV is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). Possible symptoms include weight loss, digestive issues, fever, vomiting, headache, sore throat, and painful lymph nodes. Since these symptoms can mimic other conditions like the flu and fatigue, it’s important to get tested if there is a risk you have been exposed to HIV. The virus is transmitted through blood, semen, vaginal fluids, and breast milk. The most common means of infection is through sex without a condom, or sharing a needle. HIV/AIDS is diagnosed through a blood test. There is no a cure for HIV, but medication can treat the infection.