This article was medically reviewed by Stephanie Szylar.
In this blog, ID Care certified nurse practitioner Stephanie Szylar, RN, MSN, APN-C, answers some of the many questions women have when it comes to STDs such as:
What is an STD? What are the most common STDs? What are the symptoms of STDs? How do you test for STDs? How can STDS affect women who are pregnant?
What are STDs?
According to Stephanie Szylar, APN who specializes in infectious diseases, STD stands for a sexually transmitted disease, which is an infection that can be passed by one person to another through unprotected oral, vaginal, or anal sex. We often hear the acronyms STD and STI (sexually transmitted infection), however, there is no difference between them, and they are used interchangeably. According the to the Office of Women’s Health (OASH), over 9 million women in the U.S. are diagnosed with an STD each year.
What are the Types of STDs?
Stephanie notes that there are two types of STDs: viral and bacterial. Viral infections are not curable and include viral herpes and human immunodeficiency virus (HIV), with the latter having the ability to progress to acquired immunodeficiency (AIDS) if untreated. Once a person is infected with these viruses, they stay in the body producing symptoms, and they require chronic management. On the other hand, bacterial infections such as chlamydia and gonorrhea are caused by different types of bacteria. These types of bacterial infections are treatable and curable with antibiotics once diagnosed.
What are the Most Common STDs?
ID Care states that the most common bacterial and viral STDs are chlamydia, HPV (human papillomavirus), syphilis, HIV, herpes, and gonorrhea. According to the data collected by CDC in 2019, chlamydia was found to be the most frequently encountered STD with more than 1.8 million cases reported. The Office of Women’s Health (OASH) states, “Women have a higher risk than men of getting an STI during unprotected vaginal sex. Unprotected anal sex puts women at even more risk for getting an STI than unprotected vaginal sex.” Additionally, the spread of STDs can occur in the absence of signs or symptoms. It is important to note that the transmission of STDs is possible through genital touching alone.
Below is a list of some of the most common STDs in the United States.
- HIV – a virus that attacks the body’s immune system and can eventually lead to AIDS if not managed. This virus can be transmitted through blood, semen, or vaginal fluid.
- Herpes – a viral infection caused by the herpes simplex virus (HSV-1 & HSV-2) and is transmitted by direct skin contact during oral, vaginal, or anal sex as well as kissing.
- HPV (Human Papillomavirus) – a viral infection and the most common STD in the US, with 100 types of HPV. It can be transmitted through oral, vaginal, or anal sex.
- Hepatitis B – a virus that attacks the liver and is transmitted through sex with an infected partner, direct contact with open sores, through blood by needle use, and during birth if a mother is infected.
Bacterial STIs
- Chlamydia – caused by the bacteria called, Chlamydia trachomatis, and can be transmitted through semen, vaginal fluid, or even genital contact.
- Gonorrhea – caused by the bacteria called, Neisseria gonorrhoeae, and can be transmitted through all forms of sex and genital contact.
- Syphilis – caused by the bacteria called, Treponema pallidum, and can be transmitted by direct contact with another person’s sore (chancre) during vaginal, anal, or oral sex.
What are Warning Signs of an STD that Women Should Look Out for?
“Women may or may not have signs or symptoms at all”, states Stephanie, “and some of the reasons we may delve in a little bit further are if women are sexually active, have a history of being sexually active, or present any kind of symptoms. Unfortunately, you can have herpes for years and years and not know it. It’s better to get it looked at and have been nothing than not get it looked at and it’s something.” Some STDs or STIs do not exhibit any symptoms, however, if any of the following are present, it is important to seek medical attention:
- Bleeding in between periods
- Any kind of pelvic pain
- Unusual vaginal discharge
- Burning when urinating
- Frequency and urgency when urinating
- Sightings of any sores
- Vaginal itchiness or rashes
- Discomfort or pain during sex
How Do You Test for STDs in Women?
“Sometimes STDs are picked up in women during a screening or if the partner tested positive, then they go for specific testing. If you’re at a higher risk, you’d want to be tested more often.” Stephanie explains, if you’re suspicious, the best thing to do is go to the doctor for testing to get treated for the right infection. For women, a pap smear will only check for precancerous and cancerous cells and not STDs per se. STD testing or screening may include the following:
- Pelvic and physical exam to detect any warts, unusual rashes, or discharge
- Blood tests to test for any STDs
- Urine test to determine traces of an STD
- Cotton swab sample of tissue or discharge for further testing
How Do STDs Impact Pregnant Women?
“Some of these STDs get passed along while the baby is being delivered and can also be passed along through breast milk”, states Stephanie. It’s important to get screened for STDs once it is confirmed that you are pregnant. Some STDs can also cause women to have premature labor. According to womenshealth.gov, some harmful effects of passing an STD to the baby may include low birth weight, pneumonia, brain damage, blindness, chronic liver disease, stillbirth, among others. So proactive screening is essential.
Can STDs Lead to Other Illnesses?
Stephanie notes that STDs can lead to additional illnesses, especially in women. Chlamydia or gonorrhea if left untreated can cause other conditions such as Pelvic Inflammatory Disease (PID), which can lead to infertility. An HPV infection can lead to genital warts, while HPV and Hepatitis B infections can both lead to cervical cancer or liver cancer. And HIV can progress to AIDS (acquired immunodeficiency syndrome). So proactive medical care by an infectious disease expert and other allied medical specialists is key to avoid progression of the disease.
How Do You Prevent STDs?
“Good, open communication between partners is always key”, states Stephanie. Abstinence is the best way of preventing STDs. However, if you opt to engage in any kind of sexual activity, there are risky behaviors that can be avoided and steps to follow to ensure the best practices are taking place. According to the experts at ID Care, sexually active individuals should:
- practice safe sex by using a condom
- get tested for STDs regularly in addition to a pap smear
- have open and honest communication with your partner
- have sex with a partner that agrees to only have sex with you
- get the HPV vaccine (female ages 9 – 26) as well as the Hepatitis B vaccine
- avoid high risk behaviors including multiple partners, drug use, and alcohol use
What are Considered Non-STD Infections?
Women are also affected by other vaginal infections that are not considered sexually transmitted diseases such as bacterial vaginosis (BV), urinary tract infections (UTIs), and yeast infections.
- Bacterial Vaginosis (BV) is an overgrowth of bacteria that affects women in child-bearing ages 14 – 49 and you may or may not have symptoms. If symptoms are present, there is an unusual discharge which is treated with a course of antibiotics. If testing positive for BV, it is recommended to get tested for STDs.
- Urinary Tract Infection (UTI) – A UTI is mainly caused by bacteria that gets trapped in the bladder (urinary tract). Stephanie notes that the most common bacteria is E-coli. Symptoms may include urgency, frequency, and burning when urinating, as well as incontinence, some pelvic pain, lower back pain, sometimes even a fever. As women get older, they have vaginal atrophy after menopause due to lower estrogen levels which can create a breeding ground for infections like a UTI. Fortunately, a UTI can be treated with antibiotics. Stephanie explains there are some ways to avoid getting a UTI by doing the following:
- always wipe front to back
- do not hold back the need to urinate
- drink a lot of fluid, especially water, to flush out bacteria
- drink cranberry juice according to some researchers
- Yeast Infections are fungal infections caused by a fungus called Candida albicans, affecting as many as 3 out of 4 women. High blood sugar, diabetes, and antibiotic use can contribute to the development of a yeast infection. Women who take antibiotics, are prone to yeast infections because those antibiotics tend to kill normal flora and they get an overgrowth of the fungus that could already be present. Symptoms could be irritation, itchiness, cottage cheese-like discharge, redness, and swelling. Women that test positive for a yeast infection can be treated by an antifungal medication or a vaginal suppository.
When Should You See an Infectious Disease Specialist for an STD?
It is common for women to turn to their primary care physicians and gynecologists as they know and trust them to guide their overall health and sexual wellbeing. But there are times when a woman should consider seeing an infectious disease expert, whether referred by their primary physician or by making an appointment directly if they are experiencing symptoms that go unresolved. Infectious disease specialists, like those at ID Care, are expert in all aspects of STIs and can quickly diagnose and make recommendations to ensure rapid treatment and resolution of the situation. Infectious disease experts can also work with a woman’s primary physician or GYN, as many referrals come from them, especially in complex situations when complications from pregnancy are involved or if reoccurring infections are impacting quality of life.
How Can ID Care’s Infectious Disease Experts Help You?
The expert infectious disease specialists at ID Care are here to address any concerns you may have about STDs or STIs, or if you believe you may be infected. As the largest independent infectious disease practice on the East Coast, ID Care is always up to date on the latest information and treatments available for STDs and all infectious diseases. To learn more, visit idcare.com or call 908-281-0610 to schedule an appointment with an ID Care expert.