Topic Overview

Aside from colds and the flu, sexually transmitted diseases (STDs) are some of the most widespread diseases both in the United States and the world. STDs affect both men and women, and two-thirds of all STDs occur in people younger than 25 years old. Exposure to an STD 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 STDs can be passed by nonsexual contact, such as by sharing needles or during the delivery of a baby or during breast-feeding. Sexually transmitted diseases (STDs) are also called sexually transmitted infections (STIs).

STDs are a worldwide public health concern because there is more opportunity for STDs to be spread as more people travel and engage in sexual activities. Some STDs have been linked to an increased risk of certain cancers and infection with human immunodeficiency virus (HIV) . Pregnant women can spread STDs to their babies. Many people may not have symptoms of an STD but are still able to spread an infection. STD testing can help find problems early on so that treatment can begin if needed. It is important to practice safe sex with all partners, especially if you or they have high-risk sexual behaviors. See the Prevention section of this topic.

Common sexually transmitted diseases

There are at least 20 different STDs. They can be caused by viruses, bacteria, and protozoa. Some of the most common STDs 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 STDs, 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 STDs can be treated and cured, but STDs caused by viruses usually cannot be cured. You can get a bacterial STD over and over again, even if it is one that you were treated for and cured of in the past.

For more information on the symptoms, treatment, and possible complications of specific STDs, see the specific topic in Related Information.

Sexually active teens and young adults

Sexually active teenagers and young adults are at high risk for STDs because they have biological changes during the teen years that increase their risk for getting an STD 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 over half of all new STDs each year.
  • Have the highest rates of chlamydia.
  • Ages 15 to 19 years old, have the highest rates of gonorrhea.
• About 1 in 4 teen girls gets an STD.
• About 1 in 5 teens and adults gets genital herpes, and it is more common in women than in men.
• As many as half of all sexually active men and women have been infected with genital types of human papillomavirus (HPV) at some time in their lives.
• Syphilis rates have increased, and it is most common in men ages 35 to 39 years old.
• New HIV infections have increased in people between 13 and 29 years old.

It is important to seek treatment if you think you may have an STD or have been exposed to an STD. Most health departments, family planning clinics, and STD clinics provide confidential services for the diagnosis and treatment of STDs. Early treatment can cure a bacterial STD 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 safe sex, preventing STDs, and being evaluated and treated for STDs.

Risks specific to women with sexually transmitted diseases

In women, STDs 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 .

STDs 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 diseases

• Infection and inflammation of the epididymis , urethra , anus, and prostate

Any child or vulnerable adult with symptoms of an STD 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 STD or have been exposed to an STD whether by oral, anal, or vaginal sexual activity,use the Check Your Symptoms section to decide if and when you should see a doctor.

Check Your Symptoms

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Home Treatment

Home treatment is never an appropriate treatment for a sexually transmitted disease (STD) . Evaluation by a health professional is needed for:

• Any changes or symptoms in the genital area that suggest an STD.
• A known or suspected exposure to an STD.

Symptoms of STDs may not appear for many days, weeks, months, or, with HIV , even years after an exposure. After you have been exposed to an STD, 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 STD.

In addition to your health professional, there are other resources that can help you with information on STD evaluation and treatment. These resources include:

• Local health departments that have STD 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 STD 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. STDs 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 STD to prevent the infection from returning. You may need to be rechecked after treatment is complete.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if they persist or become more severe or frequent.

Note:

If you suspect you may have symptoms of an STD: 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 STDs are available but it is recommended that you consult your health professional about any STD symptoms.

Prevention

You can take measures to reduce your risk of becoming infected with a sexually transmitted disease (STD) . You can also reduce the risk of transmitting an STD to your sex partner.

Delay sexual activity until you are prepared both physically and emotionally to have sex. Nearly two-thirds of all STDs occur in people younger than 25 years old. Sexually active teenagers are at high risk for STDs because they frequently have unprotected sex and have multiple partners. Biological changes during the teen years also may increase their risk for getting an STD.

There is a vaccine that can help prevent genital warts, human papillomavirus (HPV) , and cervical cancer . In 2006, the U.S. Food and Drug Administration (FDA) approved Gardasil ( HPV vaccine (What is a PDF document?) ). This vaccine protects against four types of HPV, which together cause most cases of cervical cancer and genital warts. Gardasil is recommended for girls 11 to 12 years old. It is also recommended for females 13 to 26 years old who did not receive it when they were younger. ¹ For more information, see the topic Immunizations.

STDs are a concern worldwide. It is important to practice safe 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 STDs practice safe sex because an STD can affect their baby ( fetus ). An STD may threaten the life of your baby or cause serious long-term problems or disabilities for your baby.

Practice safe sex

Preventing a sexually transmitted disease (STD) is easier than treating an infection once it occurs.

• Talk with your partner about STDs before beginning a sexual relationship. Find out whether he or she is at risk for an STD. Remember that it is quite possible to be infected with an STD without knowing it. Some STDs, 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 STD?
  • Was it treated and cured?
  • If the STD is not curable, what is the best way to protect yourself?
• Be responsible.
  • Avoid sexual contact or activity if you have symptoms of an STD or are being treated for an STD.
  • Avoid sexual contact or activity with anyone who has symptoms of an STD or who may have been exposed to an STD.
• Don't have more than one sex partner at a time. Your risk for an STD increases if you have several sex partners at the same time.
• Some STDs can also be spread through oral-to-genital or genital-to-anal sexual contact.
• Abstain from sexual intercourse to prevent any exposure to STDs.

Condom use

Condoms can protect you against sexually transmitted diseases (STDs). Even if you are protected against pregnancy by birth control pills or another method, use a condom to prevent STDs.

Male condom use

Using condoms reduces the risk of becoming infected with most STDs, especially if they 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 STD. See male condom use.

• 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 STDs 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 STD. Female condoms are available for women whose partners do not have or will not use a male condom. See female condom use.

Condoms do not prevent skin-to-sore contact in the genital area so it is possible to spread an STD 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 disease 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 STD.

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 topic Making 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 STD , 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 STD 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 STD symptoms:
  • What was the date of your suspected exposure to an STD?
  • Which STD 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 STDs:
  • Which STD 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?
• Have you had sexual contact or activity with an immigrant or while traveling in another country with a native person there?
• 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 STD, 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 STD prevention options.
• For women who are breast-feeding, discuss the risk of medicines being transmitted in breast milk.

Other Places To Get Help

Online Resource

American Social Health Association
Web Address:	www.ashastd.org
The American Social Health Association provides accurate, medically reliable information about sexually transmitted diseases (STDs) to the public, patients, providers, and policymakers. Its Web site has resources to answer your questions as well as to help you find referrals, join help groups, and get access to in-depth information about STDs. You can also get information over the phone by calling 1-800-227-8922.

Organizations

Centers for Disease Control and Prevention (CDC): National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
1600 Clifton Road
Atlanta, GA  30333
Phone:	1-800-CDC-INFO (1-800-232-4636) (404) 639-3534
TDD:	1-888-232-6348
E-mail:	cdcinfo@cdc.gov
Web Address:	www.cdc.gov/nchstp/od/nchstp.html
The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention is a branch of the Centers for Disease Control and Prevention (CDC). Its Web site provides information and updates on sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), and tuberculosis (TB). You can also find fact sheets on these health topics.
Planned Parenthood Federation of America
434 West 33rd Street
New York, NY  10001
Phone:	1-800-230-PLAN (1-800-230-7526) (212) 541-7800
Fax:	(212) 245-1845
Web Address:	www.plannedparenthood.org
The Planned Parenthood Federation of American provides comprehensive reproductive health care and consumer information about family planning, sexual health, and sexually transmitted diseases (STDs).
Sexuality Information and Education Council of the U.S. (SIECUS)
90 John Street
Suite 704
New York, NY  10038
Phone:	(212) 819-9770
Fax:	(212) 819-9776
Web Address:	www.siecus.org
Sexuality Information and Education Council of the U.S. (SIECUS) develops, collects, and gives out information; promotes comprehensive education about sexuality, including sexually transmitted diseases; and advocates for the right of individuals to make responsible sexual choices.

Related Information

• Abnormal Vaginal Bleeding

References

Citations

1. U.S. Department of Health and Human Services (2007). HPV Vaccine: Questions and Answers. Available online: http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm.

Credits

Author	Jan Nissl, RN, BS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Tracy Landauer
Primary Medical Reviewer	Joy Melnikow, MD, MPH - Family Medicine
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	Jeanne Marrazzo, MD, MPH - Infectious Disease
Specialist Medical Reviewer	William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Last Updated	December 11, 2008