Dude, what’s that lump? A guy’s guide to STIs
So you’ve spotted a lump…down there…and you’re a little nervous. It could be nothing. Maybe it’ll go away by itself. Right?
There are times where we might play the ‘wait and see’ game, but it’s not wise to gamble when it comes to sexual health. Paying attention to changes in your body and taking action when things don’t seem right is important because sexual health isn’t just about you – it’s about your partners’ health, too.
But as you’ll see, being smart about sexually transmissible infections (STIs) is more than just looking for odd bumps and lumps.
What are STIs?
STIs are infections that can be transmitted during sexual intercourse, including vaginal, anal and oral sex. They occur when viruses, bacteria or parasites pass from one person’s body to another’s during sex or intimate skin-on-skin contact. Some STIs affect an isolated area only, like the genitals, while others can spread and cause damage in other parts of the body.
How do I spot an STI?
You might be surprised to learn that most STIs don’t have symptoms. This means you can’t necessarily tell if you or your sexual partner has an STI just by looking. That’s why regular sexual health check-ups are essential.
Because STIs are so common and testing is quick and easy, many clinicians suggest getting an STI test every 6–12 months, when you change partners, or if you have any symptoms that you’re concerned about.
It's also important to know that being treated for STIs doesn’t stop you from getting them again.
Queensland’s most common STIs, and their symptoms in men
STI symptoms can be different between men and women. We’ll take a closer look at men’s symptoms here, but for more information check out our blog on Queensland’s most commonly diagnosed STIs.
If you’ve got odd lumps in intimate places, there’s a chance it’s either genital herpes or genital warts. Both are caused by viruses and can be transmitted through unprotected vaginal, oral and anal sex or intimate skin-on-skin contact.
Genital herpes is a very common STI. In fact, it’s estimated that 1 in 10 sexually active adults in Australia have genital herpes. The virus that causes genital herpes can lay dormant in the body for many years. This means you might have symptoms straight away, or not for many years after contracting it.
For men, the typical symptoms of genital herpes include:
- outbreaks of small, painful blisters
- outbreaks of a rash that looks like cracked skin
- stinging or tingling in the infected area
- difficulty urinating.
After first contracting the virus, you may also experience flu-like symptoms such as fever, headaches and swollen glands.
Symptoms typically occur in episodes, with each lasting around 7 to 10 days. Currently there is no cure for genital herpes, but treatments are available that can reduce the length and severity of each episode. The virus that causes genital herpes stays in the body for the rest of your life, and the symptoms can recur over time. For more information, watch our animation about herpes.
Genital warts can be caused by different types of human papillomavirus (HPV). The HPV strains that cause genital warts are different to those that are associated with certain cancers.
For men, genital warts can appear on the penis, scrotum, or anus. Genital warts can be:
- bumpy, flat, or appear in clusters
- painless, but are sometimes painful, itchy, or uncomfortable.
Wart treatments are available, but only your immune system can clear the virus. This means the virus can linger even if the warts aren’t visible.
Chlamydia is the most common bacterial STI in Queensland and in the world. In Australia, the vast majority of chlamydia infections in young people remain undiagnosed and therefore untreated. Without treatment, it can lead to serious health issues down the track, including infertility, yet most uncomplicated chlamydia infections are easy to treat with a single dose of antibiotics.
For men, the symptoms of chlamydia can include:
- discharge from the penis
- discomfort or irritation at the tip of the penis from the urethra
- pain when urinating
- swollen and sore testes
- pain in the rectum and discharge from the anus if spread through anal sex.
People who have contracted chlamydia may not have any symptoms at all. For more information, watch our animation about chlamydia.
Gonorrhoea is another STI that can occur without symptoms and it is on the rise in Queensland. Untreated gonorrhoea infections are not only potentially uncomfortable and unpleasant, but they can also lead to serious issues down the track. Gonorrhoea can infect the testes and lead to infertility. It can also increase the risk of HIV transmission.
For men, the symptoms of gonorrhoea can include:
- a yellow discharge from the penis
- pain and/or burning sensation when urinating
- swollen and sore testes.
If contracted through anal sex, the symptoms of gonorrhoea can include:
- pain in the rectum (the end of the large intestine that joins to the anus)
- discharge or mucus from the anus, which might be bloody
- feeling of fullness in the lower bowel.
If contracted through oral sex, the symptoms of gonorrhoea can include:
- a sore, red throat
- pus on the tonsils.
Symptoms can appear but then go away after a couple of weeks, but that doesn’t mean the infection is gone. Only antibiotics can clear a gonorrhoea infection and most uncomplicated infections are easy to treat with a single dose of antibiotics. However, some types of gonorrhoea are resistant to some drugs and can therefore be more complex to treat. For more information, watch our animation about gonorrhoea.
Syphilis is also on the rise in Queensland. Like chlamydia and gonorrhoea, you can have it and not experience any symptoms. It’s a serious infection that, if left untreated, can be fatal. Syphilis presents in three stages, each with its own list of possible symptoms.
Early on, you might get sores, rashes and ulcers of different shapes and sizes. You might think it’s genital herpes or a really bad heat rash and the sores might go away, but if it is syphilis, the infection is still in the body.
After 2-6 months, the symptoms of syphilis infection can include:
- a flu-like illness
- a rash on the abdomen, palms and soles of feet
- swollen glands
- wart-like lumps around the moist areas of the body (groin, armpits)
- hair loss
- pains in the muscles, bones and joints.
These symptoms might also go away on their own, but the infection remains. Over time, an untreated syphilis infection can spread to other internal organs like the heart and brain, causing serious and even life-threatening complications.
Syphilis is a particularly dangerous infection for pregnant women as it can cause congenital syphilis for the baby. Congenital syphilis can be life threatening to babies. If your partner is pregnant or hoping to be pregnant one day, you can protect her reproductive health by taking care of your own.
For more information, watch our animation about syphilis.
How to prevent STIs
Practice safe sex and use a condom or dental dam every time you have vaginal, anal or oral sex. Condoms and dental dams are the only types of contraception that offer protection against most STIs. For more information, check out when and why you should use condoms, how to use them correctly, and learn to transform a condom into a dental dam.
If you and your partner make the decision not to use condoms, ensure you both get sexual health checks and complete treatment if necessary first.
What to do if you think you might have an STI
By now it should be obvious that STIs aren’t just about lumps. They can be serious, and some stay with you for life. The list of STIs is long, and the symptoms can vary, which is why regular sexual health checks are essential in protecting your overall health.
If you think you have an STI, or if you haven’t been tested in a while, book in for a sexual health check with your doctor. Don’t worry, they’ve seen it all before, and the sooner you get in and have it sorted, the better. STIs can usually be easily treated with medications like antibiotics. For those that can’t, your doctor can help you manage your symptoms and reduce the risk of transmitting the infection to others.
You can also order a free urine test online for chlamydia and gonorrhoea through the 13 HEALTH webtest program. There are two options to provide urine for a webtest:
- Download a pathology form and give a urine sample at your local pathology collection centre. This is the quickest way to get your results.
- Order a home mailing kit and post your urine sample in the reply-paid envelope to be analysed.
The webtest program doesn’t replace a sexual health check, but it can be useful if you can’t get to a health service. 13 HEALTH webtest cannot test for syphilis or HIV, or for throat and anal infections.
If you find out you’ve contracted an STI, you should talk to any current or past sexual partners so they can get tested and treated too. Your doctor can give advice on who you need to tell and how to tell them, and this guide on contact tracing may help as well. In some cases it might be better for a health professional to contact partners for you, so talk to them about this option if you are concerned.
Even if you don’t think you have an STI, if you’re sexually active and don’t use a condom every time, commit to getting a sexual health check at least once a year. Remember that many people with STIs don’t experience symptoms. It’s only through regular testing that you can be sure you’re STI-free.
Let’s talk about sex, baby! Your ultimate guide to sexual health
Oral sex and STIs - what you need to know
Stop the rise of STIs
Queensland Government: Sexual health
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Last updated: 9 July 2019
Syphilis – CDC Fact Sheet
Syphilis is a sexually transmitted disease (STD) that can have very serious complications when left untreated, but it is simple to cure with the right treatment.
What is syphilis?
Syphilis is a sexually transmitted infection that can cause serious health problems if it is not treated. Syphilis is divided into stages (primary, secondary, latent, and tertiary). There are different signs and symptoms associated with each stage.
How is syphilis spread?
You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth. Syphilis can spread from an infected mother to her unborn baby.
Example of a primary syphilis sore.
What does syphilis look like?
Syphilis is divided into stages (primary, secondary, latent, and tertiary), with different signs and symptoms associated with each stage. A person with primary syphilis generally has a sore or sores at the original site of infection. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually (but not always) firm, round, and painless. Symptoms of secondary syphilis include skin rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed. During the latent stage, there are no signs or symptoms. Tertiary syphilis is associated with severe medical problems. A doctor can usually diagnose tertiary syphilis with the help of multiple tests. It can affect the heart, brain, and other organs of the body.
How can I reduce my risk of getting syphilis?
The only way to avoid STDs is to not have vaginal, anal, or oral sex.
If you are sexually active, you can do the following things to lower your chances of getting syphilis:
- Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis;
- Using latex condoms the right way every time you have sex. Condoms prevent transmission of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.
Am I at risk for syphilis?
Any sexually active person can get syphilis through unprotected vaginal, anal, or oral sex. Have an honest and open talk with your health care provider and ask whether you should be tested for syphilis or other STDs.
- All pregnant women should be tested for syphilis at their first prenatal visit.
- You should get tested regularly for syphilis if you are sexually active and
I’m pregnant. How does syphilis affect my baby?
If you are pregnant and have syphilis, you can give the infection to your unborn baby. Having syphilis can lead to a low birth weight baby. It can also make it more likely you will deliver your baby too early or stillborn (a baby born dead). To protect your baby, you should be tested for syphilis at least once during your pregnancy. Receive immediate treatment if you test positive.
An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies can have health problems such as cataracts, deafness, or seizures, and can die.
Secondary rash from syphilis on palms of hands.
What are the signs and symptoms of syphilis?
Symptoms of syphilis in adults vary by stage:
During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. Sores are usually (but not always) firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore usually lasts 3 to 6 weeks and heals regardless of whether or not you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.
During the secondary stage, you may have skin rashes and/or mucous membrane lesions. Mucous membrane lesions are sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can look like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet. The rash usually won’t itch and it is sometimes so faint that you won’t notice it. Other symptoms you may have can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired). The symptoms from this stage will go away whether or not you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.
Secondary rash from syphilis on torso.
The latent stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. If you do not receive treatment, you can continue to have syphilis in your body for years without any signs or symptoms.
Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death.
Neurosyphilis and Ocular Syphilis
Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis) or to the eye (ocular syphilis). This can happen during any of the stages described above.
Symptoms of neurosyphilis include
- severe headache;
- difficulty coordinating muscle movements;
- paralysis (not able to move certain parts of your body);
- numbness; and
- dementia (mental disorder).
Symptoms of ocular syphilis include changes in your vision and even blindness.
Darkfield micrograph of Treponema pallidum.
How will I or my doctor know if I have syphilis?
Most of the time, a blood test is used to test for syphilis. Some health care providers will diagnose syphilis by testing fluid from a syphilis sore.
Can syphilis be cured?
Yes, syphilis can be cured with the right antibiotics from your health care provider. However, treatment might not undo any damage that the infection has already done.
I’ve been treated. Can I get syphilis again?
Having syphilis once does not protect you from getting it again. Even after you’ve been successfully treated, you can still be re-infected. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your health care provider is recommended to make sure that your treatment was successful.
It may not be obvious that a sex partner has syphilis. This is because syphilis sores can be hidden in the vagina, anus, under the foreskin of the penis, or in the mouth. Unless you know that your sex partner(s) has been tested and treated, you may be at risk of getting syphilis again from an infected sex partner.
Where can I get more information?
Syphilis and MSM – Fact Sheet
Congenital Syphilis – Fact Sheet
STDs during Pregnancy – Fact Sheet
STD information and referrals to STD Clinics
In English, en Español
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Centers for Disease Control and Prevention (2017). Chlamydia-CDC fact sheet. Available online: http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm.
U.S. Preventive Services Task Force (2014). Chlamydia and gonorrhea screening: Final recommendation statement. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening. Accessed October 14, 2014.
Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03): 1-137. http://www.cdc.gov/std/tg2015. Accessed July 2, 2015. [Erratum in MMWR, 64(33): 924. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a9.htm?s_cid=mm6433a9_w. Accessed January 25, 2016.]
Centers for Disease Control and Prevention (2010). Chlamydial infections section of Sexually transmitted diseases treatment guidelines, 2010. MMWR, 59(RR-12): 44-49. Also available online: http://www.cdc.gov/std/treatment/2010/default.htm.
What STDs can you get from oral sex?
Anyone who engages in oral sex with somebody who has a sexually transmitted disease can contract the disease themselves.
Oral sex refers to when a person puts their mouth, tongue, or lips on the genitals or anus of another person.
Sexually transmitted diseases (STDs) that people can pass on through oral sex can infect multiple parts of the body, including the:
In this article, we take a look at STDs that people can spread through oral sex and their signs and symptoms.
We also cover how people can transmit these STDs, along with their treatment options.
Gonorrhea is an STD that Neisseria gonorrhoeae bacteria cause.
Gonorrhea does not always cause symptoms. If people do notice symptoms, they may include:
- a burning sensation when urinating
- a sore throat
- unusual discharge from the vagina, penis, or rectum
- swelling or pain in the testicles
- pain in the rectum
People can get gonorrhea as a result of having oral sex with someone who has a gonorrhea infection in the throat, vagina, penis, urinary tract, or rectum.
Diagnosis and treatment
A doctor can take a urine sample to test for gonorrhea. They may also take a swab from the:
- urethra in males
- cervix in females
Gonorrhea is treatable with antibiotics, though some strains have now become resistant to antibiotics.
If people continue to experience symptoms after receiving treatment for gonorrhoea, they should see their doctor again.
If a person does not seek treatment for gonorrhea, it can cause serious health complications, including:
Chlamydia is a common bacterial infection that Chlamydia trachomatis bacteria can cause.
Chlamydia infections often have no symptoms.
However, if a person has a chlamydia infection in their throat, they may have a sore throat.
If they have an infection of the rectum, genitals, or urinary tract, symptoms may include the following:
- unusual discharge, such as blood, from the vagina, penis, or rectum
- a burning sensation when urinating
- pain in the rectum
- swelling or pain in the testicles
People can get chlamydia as a result of having oral sex with someone who has a chlamydia infection. People with a chlamydia infection in the throat, vagina, penis, or rectum can pass on the infection.
Diagnosis and treatment
Doctors can diagnose chlamydia by taking a urine sample or a vaginal swab for females.
People can treat chlamydia by taking antibiotics. They should avoid having sex until they have completed the course of treatment.
Chlamydia is treatable with antibiotics. It is important that people seek treatment for chlamydia, as it can spread to a sexual partner if they do not treat it.
It can also cause serious health problems, including:
Syphilis is a bacterial infection that Treponema pallidum cause.
People may not notice any symptoms from syphilis, and the first signs are usually mild. There are four stages of a syphilis infection, and each stage has different symptoms:
- firm, round sores at the site of infection, which may be painless
Sores can last for and are self-healing. When the sore heals, the infection is still present. For this reason, it is important that a person continues to receive treatment.
Even if these symptoms pass without treatment, it is essential that people still get treatment to remove the infection and prevent it from progressing to further stages.
The latent stage of syphilis has no symptoms. Without treatment, people may have a syphilis infection for many years without noticing any symptoms.
People do not usually develop tertiary syphilis, but it can happen after first getting the infection if they do not seek testing and treatment at the time.
People may notice severe complications if they have tertiary syphilis, which may include:
- damage to internal organs
- changes in vision
Neurosyphilis occurs when syphilis spreads to the brain or nervous system. Symptoms of neurosyphilis can include:
- difficulty moving parts of the body
Tertiary syphilis can be fatal if a person does not receive treatment.
People can get syphilis by engaging in oral sex with a person who has syphilis, specifically by coming into direct contact with a syphilis sore or rash.
Diagnosis and treatment
A doctor will take a blood test to check whether a person has syphilis. If people have sores, a doctor may test fluid from the sore.
The earlier people receive treatment for syphilis, the easier it is to cure. Doctors can use a penicillin injection to treat type of this infection.
Syphilis can cause severe complications and can even be fatal if a person does not receive treatment. If left untreated, syphilis can cause:
- increased risk of HIV
- damage to organs
If someone has a syphilis infection while pregnant, they can also pass the infection to their baby.
Human papillomavirus (HPV) is the STD in the United States, according to the Centers for Disease Control and Prevention (CDC).
People with HPV may have no symptoms. However, HPV can cause:
- warts on or around the genitals or anus
- warts in the throat
If people have warts in the throat, they may feel breathless or have difficulty speaking.
People can get HPV through giving oral sex to anyone who has an HPV infection in the genital area, anus, or rectum.
People with an HPV infection in the throat can also pass on the infection by giving oral sex to a partner.
Diagnosis and treatment
There is that healthcare providers use to detect HPV, especially in the mouth or throat. Some people may find out that they have HPV if they get an abnormal test result from cervical cancer screening, or a Pap smear.
Others may find out that they have it if they develop genital warts or other complications.
People can treat warts from an HPV infection but not the virus itself. A person can remove warts by taking certain medicines or undergoing surgery. Sometimes, the warts disappear by themselves.
HPV often goes away without treatment.
Even if people treat the warts, they can still spread the HPV infection to sexual partners.
Some types of HPV can cause cancer, including cervical cancer. Many females do not develop cervical cancer if they receive the correct treatment for HPV.
People can get an HPV vaccine to help protect against the diseases that HPV can cause.
Herpes is an infection that the herpes simplex virus can cause.
Herpes often produces no symptoms, or very mild ones. The main symptoms following initial infection may include:
- painful or itchy sores around the genital area, rectum, or mouth
- aching body
- swollen glands
People can get herpes as a result of having oral sex if a partner has a herpes infection in the mouth, genital area, rectum, or anus.
Diagnosis and treatment
A doctor may take a skin sample from a sore for testing, or they may perform a blood test to help diagnose herpes.
Although there is no cure for herpes, people can take antiviral medicine to reduce or prevent the symptoms.
With or without treatment, people can spread herpes infections to sexual partners. Taking daily medicine can help reduce the chance of passing on the infection, however.
Having herpes can increase the risk of getting an HIV infection, and pregnant women can pass on herpes to their infant.
Trichomoniasis, or trich, is a common infection that a parasite causes.
Symptoms can include:
- unusual discharge from the vagina or penis
- redness or itching around the vagina
- a burning sensation when urinating
If people give oral sex to a partner who has a trichomoniasis infection in the vagina or penis, they may get a trichomoniasis infection in the throat.
Diagnosis and treatment
People will need to see their healthcare provider for laboratory tests to check for trichomoniasis, as a doctor cannot diagnose it just from the symptoms.
People can treat trichomoniasis by taking a single dosage of antibiotic medicine that can also destroy parasites.
To prevent getting another infection, people should make sure that their sexual partners also receive treatment.
People can easily treat trichomoniasis by taking oral medication.
Hepatitis A is a virus that causes inflammation of the liver.
The symptoms of hepatitis A tend to develop after an average of 28 days from exposure to the virus. These symptoms can include:
Hepatitis A transmission mainly occurs through oral-fecal contact. As a result, a person could contract hepatitis A by performing oral-anal sex with someone who has the virus.
Diagnosis and treatment
Blood tests can detect the hepatitis A virus if someone has it.
There is no cure for the virus, so doctors will often recommend that a person with the infection rests for 1–4 weeks and avoids intimate contact with other people.
Although hepatitis A can make people feel very unwell, it rarely causes any complications.
Hepatitis B is another virus that causes inflammation of the liver.
In many cases, hepatitis B causes few or no symptoms. When symptoms do appear, they can include:
- a rash
- joint pain and stiffness
- loss of appetite
- yellowing of the skin and eyes
- dark urine
- pain or discomfort in the abdomen
People with a hepatitis B infection can pass on the virus in their semen or vaginal secretions during oral sex.
Diagnosis and treatment
Doctors can diagnose hepatitis B by performing a blood test. It can take anywhere between 3 weeks and 2 months for the virus to appear in a person’s blood. The test will determine if the infection is acute or chronic.
There is no specific treatment for an acute hepatitis B infection, and most people will fully recover after a short amount of time.
Doctors will treat a chronic hepatitis B infection with medication to slow the progression of the virus and support the immune system. People with an acute infection will typically make a full recovery once the virus has run its course.
In severe cases, hepatitis B can lead to chronic infection, scarring of the liver, liver cancer, and even death. A vaccine is available to help protect people from this virus, however.
HIV is a virus that affects the immune system, making people with it more prone to other illnesses.
A person will need to undergo a test to receive a diagnosis of HIV, as it does not always cause symptoms.
The symptoms that a person experiences depend on the stage of the HIV virus.
People may experience symptoms similar to the flu, which can include:
- aching muscles
- a sore throat
- swollen lymph glands
- night sweats
Clinical latency stage
People may experience mild symptoms or none at all during this stage.
The risk of passing on HIV through oral sex is very low, and the person giving oral sex would need to have an open wound in their mouth in order to catch it.
With the correct treatment, a person with HIV cannot transmit the virus to another person.
Diagnosis and treatment
A healthcare provider can perform a blood or saliva test to determine whether a person has HIV.
Although there is currently no cure for HIV, it is possible to manage the condition effectively with the correct treatment. Treatment for HIV consists of a regimen of antiretroviral drugs called antiretroviral therapy.
If people with HIV take medications as prescribed, they can reduce the amount of the virus in their bloodstream to an undetectable level.
They can live a long and healthy life and avoid passing it on to sexual partners.
If people are having sexual intercourse or oral sex, they can take the following steps to help prevent STDs:
- use a condom every time they have sex
- use a dental dam every time they have oral sex
- be in a mutually monogamous relationship where both partners have had STD tests
- get regular tests for STDs
If a person does not have access to a dental dam, they can make one at home using a condom. To make a dental dam, follow these steps:
- Cut off the tip of the condom.
- Cut off the elastic ring at the base of the condom.
- Make one cut down the length of the condom.
- Open the condom up into a square.
- Place the dental dam across the vaginal or anal area.
There are many types of STD that people can transmit or contract as a result of having oral sex.
People can use a condom or a dental dam to help protect themselves and their sexual partners from STDs.
If a person has an STD, it is important that they and their sexual partners receive the correct treatment to prevent any complications arising.
By using appropriate prevention methods and receiving treatment when necessary, people should be able to enjoy oral sex without the risk of STDs.
Bumps chlamydia red
Everything you need to know about chlamydia
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Chlamydia is a sexually transmitted bacterial infection. It affects both males and females who contract it during sexual contact.
According to the , there were around 1.8 million cases of chlamydia in the United States in 2018. It is the most common sexually transmitted infection (STI) in the U.S.
Chlamydia often produces no symptoms, but it can lead to fertility problems. However, effective treatment is available.
In this article, we will discuss the symptoms, causes, diagnosis, and treatment of chlamydia.
Most people with chlamydia do not notice any symptoms. According to research cited by the , only around 10% of males and 5–30% of females experience symptoms.
It is also unclear how long it takes for symptoms to appear, but it may be several weeks.
In females, symptoms of chlamydia may include:
- a discharge from the cervix
- easy bleeding
- frequent or painful urination
If chlamydia spreads to the uterus and the fallopian tubes, it can result in pelvic inflammatory disease (PID). This, too, may not produce symptoms. However, it can affect fertility.
In males, symptoms may include pain, tenderness, and swelling in the testicles or the urethra, the tube that carries urine.
Males and females
Both males and females may develop symptoms in the rectum and anus. The virus can infect these areas during anal sex or by spreading from the reproductive organs.
- rectal pain
- rectal discharge or bleeding
Contact with infected secretions can also lead to chlamydial conjunctivitis (pink eye).
Laboratory tests have found chlamydia in the throat of people who have had oral sex with someone who has the infection. However, this does not usually produce symptoms.
Anyone who has or suspects they have chlamydia must seek treatment to prevent long-term health consequences, including infertility and ectopic pregnancy.
Doctors will typically prescribe antibiotics to treat chlamydia. A person will usually take antibiotics as a pill.
The recommend retesting at least every 3 months after treatment, depending on the individual’s risk factors.
Examples of antibiotics for chlamydia include:
- Azithromycin: A single 1-gram (g) dose.
- Doxycycline: 100 milligrams (mg) twice daily for 7 days
- Ofloxacin: 300–400 mg once or twice daily for 7 days
Other medication options include erythromycin and amoxicillin. A doctor may prescribe one of these during pregnancy.
Adverse effects can sometimes occur, including:
Doxycycline can sometimes trigger a skin rash if a person spends time in the sun.
In most cases, the side effects will be mild. Anyone who experiences severe adverse effects should contact their healthcare provider. Do not stop taking the medication without first checking with a doctor.
According to one source, a course of antibiotics resolves chlamydia in 95% of cases. However, it is essential to follow the doctor’s instructions and complete the whole course of treatment.
Other aspects of treatment
The recommend that people with chlamydia refrain from sex for 7 days:
- after a single-dose treatment
- while they complete a 7-day course of antibiotics
If a person has a diagnosis of chlamydia, they should inform any partners they have had sexual contact within the previous 60 days so that they, too, can seek testing and treatment.
If one partner does not receive treatment or does not complete the course of treatment, there is a risk of reinfection or transmitting the virus to someone else.
Sometimes, a doctor may also be treated for gonorrhea because the bacteria that cause the two infections often occur together.
To diagnose chlamydia, a doctor may carry out an examination to look for physical symptoms such as discharge.
They will also take either a urine sample or a swab sample from the penis, cervix, urethra, throat, or rectum.
As chlamydial infection frequently presents no symptoms, health authorities often recommend screening for some people.
The USPSTF for:
- sexually active females under 25 years of age
- pregnant women who are under 25 years or older if at high risk
- males who are in a high-risk group
- men who have sex with men annually and every 3–6 months if they are at high risk
- people with HIV who are sexually active, at least once a year
How is chlamydia screening done?
A person can test for chlamydia at home or in the lab. They can take either a urine sample or a swab.
- Females can take a swab, place it in a container, and send it to a laboratory.
- Males will usually use a urine test.
A doctor can advise individuals on the best option. They may also recommend rectal or throat testing, especially for people who are living with HIV.
Home screening tests are available, but it is not always easy to do them correctly at home. A healthcare provider will usually recommend following up on any home tests by visiting a doctor’s office.
The person will likely need to provide a urine sample for a test to confirm a diagnosis. After treatment, they will need to retake the test to ensure that the treatment has worked.
If anyone wishes to try home testing, chlamydia screening test kits are available for purchase online.
Chlamydia is an infection by the bacteria Chlamydia trachomatis (C. trachomatis).
Chlamydia infection can affect several organs, including the penis, vagina, cervix, urethra, anus, eye, and throat. It can cause severe and sometimes permanent damage to the reproductive system.
How does chlamydia spread?
A person can pass on chlamydia through unprotected oral, anal, or vaginal sex or through genital contact.
As chlamydial infection often has no symptoms, a person may have the infection and pass it on to a sexual partner without knowing.
It is not possible to pass on chlamydia through:
- contact with a toilet seat
- sharing a sauna
- using a swimming pool
- touching a surface that a person with chlamydia has touched
- standing close to a person who has the infection
- coughs or sneezes
- sharing an office or house with a colleague who has the infection
According to the , a mother who has chlamydia infection can to her baby during childbirth.
Sometimes, the infection leads to complications for the infant, such as eye infections or pneumonia.
A female who has a diagnosis of chlamydia during pregnancy will need a test 3–4 weeks after treatment to ensure the infection has not returned.
Ways of preventing chlamydia or reducing the risk of infection include:
- using condoms consistently and correctly
- limiting the number of sexual partners
- having a sexual relationship in which both partners are monogamous
- regular screening
- avoiding sex until treatment is complete
Early diagnosis and treatment can reduce the risk of complications.
Pelvic inflammatory disease (PID)
This is an infection of the ovaries, fallopian tubes, and uterus. It can lead to infertility.
According to the CDC, if chlamydia is left untreated, around of females will develop PID.
This could lead to:
- persistent pelvic pain
- ectopic pregnancy, which can be life-threatening
In some cases, chlamydial PID can lead to an inflammation of the capsule that surrounds the liver. The main symptom is pain in the upper right side of the abdomen.
The also indicate that pregnant women who have chlamydia or their baby may experience:
- preterm delivery
- early rupture of the membranes
- low birth weight
- conjunctivitis or pneumonia in the newborn
This is an inflammation of the neck of the womb.
This is an inflammation of the fallopian tubes. It increases the risk of an ectopic pregnancy.
This is an infection of the urethra. The urethra is a tube that carries urine from the bladder out of the body. Chlamydia can inflame the urethra, resulting in pain and difficulty urinating.
Sometimes this occurs alongside conjunctivitis and reactive arthritis, which is a chronic type of inflammatory arthritis.
This can affect males. It is an inflammation of the epididymis, a structure inside the scrotum.
Signs and symptoms include red, swollen, and warm scrotum, testicle pain, and tenderness.
Chlamydia is a common, sexually-transmitted bacterial infection. It often produces no symptoms, but screening can show if a person needs treatment.
Without treatment, it can lead to complications that may have permanent effects. For this reason, treatment and screening are essential for those who may be at risk.
Chlamydia – CDC Fact Sheet (Detailed)
Basic Fact Sheet | Detailed Version
Detailed fact sheets are intended for physicians and individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more in depth.
What is chlamydia?
Chlamydia is a common sexually transmitted disease (STD) caused by infection with Chlamydia trachomatis. It can cause cervicitis in women and urethritis and proctitis in both men and women. Chlamydial infections in women can lead to serious consequences including pelvic inflammatory disease (PID), tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. Lymphogranuloma venereum (LGV), another type of STD caused by different serovars of the same bacterium, occurs commonly in the developing world, and has more recently emerged as a cause of outbreaks of proctitis among men who have sex with men (MSM) worldwide.1,2
How common is chlamydia?
CDC estimates that there were four million chlamydial infections in 2018.3 Chlamydia is also the most frequently reported bacterial sexually transmitted infection in the United States.4 However, a large number of cases are not reported because most people with chlamydia are asymptomatic and do not seek testing. Chlamydia is most common among young people. Two-thirds of new chlamydial infections occur among youth aged 15-24 years.3 It is estimated that 1 in 20 sexually active young women aged 14-24 years has chlamydia.5
Disparities persist among racial and ethnic minority groups. In 2019, reported chlamydia rates for African Americans/Blacks were nearly six times that of Whites.4 Chlamydia is also common among gay, bisexual, and other men who have sex with men (MSM). Among MSM screened for rectal chlamydial infection, positivity has ranged from 3.0% to 10.5%.6,7 Among MSM screened for pharyngeal chlamydial infection, positivity has ranged from 0.5% to 2.3%.7.8
How do people get chlamydia?
Chlamydia is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for chlamydia to be transmitted or acquired. Chlamydia can also be spread perinatally from an untreated mother to her baby during childbirth, resulting in ophthalmia neonatorum (conjunctivitis) or pneumonia in some exposed infants. In published prospective studies, chlamydial conjunctivitis has been identified in 18-44% and chlamydial pneumonia in 3-16% of infants born to women with untreated chlamydial cervical infection at the time of delivery.9-12 While rectal or genital chlamydial infection has been shown to persist one year or longer in infants infected at birth,13 the possibility of sexual abuse should be considered in prepubertal children beyond the neonatal period with vaginal, urethral, or rectal chlamydial infection.
People who have had chlamydia and have been treated may get infected again if they have sexual contact with a person infected with chlamydia.14
Who is at risk for chlamydia?
Any sexually active person can be infected with chlamydia. It is a very common STD, especially among young people.3 It is estimated that 1 in 20 sexually active young women aged 14-24 years has chlamydia.5
Sexually active young people are at high risk of acquiring chlamydia for a combination of behavioral, biological, and cultural reasons. Some young people don’t use condoms consistently.15 Some adolescents may move from one monogamous relationship to the next more rapidly than the likely infectivity period of chlamydia, thus increasing risk of transmission.16 Teenage girls and young women may have cervical ectopy (where cells from the endocervix are present on the ectocervix).17 Cervical ectopy may increase susceptibility to chlamydial infection. The higher prevalence of chlamydia among young people also may reflect multiple barriers to accessing STD prevention services, such as lack of transportation, cost, and perceived stigma.16-20
Men who have sex with men (MSM) are also at risk for chlamydial infection since chlamydia can be transmitted by oral or anal sex. Among MSM screened for rectal chlamydial infection, positivity has ranged from 3.0% to 10.5%.6.7 Among MSM screened for pharyngeal chlamydial infection, positivity has ranged from 0.5% to 2.3%.7.8
What are the symptoms of chlamydia?
Chlamydia is known as a ‘silent’ infection because most infected people are asymptomatic and lack abnormal physical examination findings. Estimates of the proportion of chlamydia-infected people who develop symptoms vary by setting and study methodology; two published studies that incorporated modeling techniques to address limitations of point prevalence surveys estimated that only about 10% of men and 5-30% of women with laboratory-confirmed chlamydial infection develop symptoms.21.22 The incubation period of chlamydia is poorly defined. However, given the relatively slow replication cycle of the organism, symptoms may not appear until several weeks after exposure in those persons who develop symptoms.
In women, the bacteria initially infect the cervix, where the infection may cause signs and symptoms of cervicitis (e.g., mucopurulent endocervical discharge, easily induced endocervical bleeding), and sometimes the urethra, which may result in signs and symptoms of urethritis (e.g., pyuria, dysuria, urinary frequency). Infection can spread from the cervix to the upper reproductive tract (i.e., uterus, fallopian tubes), causing pelvic inflammatory disease (PID), which may be asymptomatic (“subclinical PID”)23 or acute, with typical symptoms of abdominal and/or pelvic pain, along with signs of cervical motion tenderness, and uterine or adnexal tenderness on examination.
Men who are symptomatic typically have urethritis, with a mucoid or watery urethral discharge and dysuria. A minority of infected men develop epididymitis (with or without symptomatic urethritis), presenting with unilateral testicular pain, tenderness, and swelling.24
Chlamydia can infect the rectum in men and women, either directly (through receptive anal sex), or possibly via spread from the cervix and vagina in a woman with cervical chlamydial infection.25, 26 While these infections are often asymptomatic, they can cause symptoms of proctitis (e.g., rectal pain, discharge, and/or bleeding).26-28
Sexually acquired chlamydial conjunctivitis can occur in both men and women through contact with infected genital secretions.29
While chlamydia can also be found in the throats of women and men having oral sex with an infected partner, it is typically asymptomatic and not thought to be an important cause of pharyngitis.26
What complications can result from chlamydial infection?
The initial damage that chlamydia causes often goes unnoticed. However, chlamydial infections can lead to serious health problems with both short- and long-term consequences.
In women, untreated chlamydia can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). Symptomatic PID occurs in about 10 to 15 percent of women with untreated chlamydia.30,31 However, chlamydia can also cause subclinical inflammation of the upper genital tract (“subclinical PID”). Both acute and subclinical PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, tubal factor infertility, and potentially fatal ectopic pregnancy.32,33
Some patients with chlamydial PID develop perihepatitis, or “Fitz-Hugh-Curtis Syndrome”, an inflammation of the liver capsule and surrounding peritoneum, which is associated with right upper quadrant pain.
In pregnant women, untreated chlamydia has been associated with pre-term delivery,34 as well as ophthalmia neonatorum (conjunctivitis) and pneumonia in the newborn.
Reactive arthritis can occur in men and women following symptomatic or asymptomatic chlamydial infection, sometimes as part of a triad of symptoms (with urethritis and conjunctivitis) formerly referred to as Reiter’s Syndrome.35
What about chlamydia and HIV?
Untreated chlamydia may increase a person’s chances of acquiring or transmitting HIV – the virus that causes AIDS.36
How does chlamydia affect a pregnant woman and her baby?
In pregnant women, untreated chlamydia has been associated with pre-term delivery,34 as well as ophthalmia neonatorum (conjunctivitis) and pneumonia in the newborn. In published prospective studies, chlamydial conjunctivitis has been identified in 18-44% and chlamydial pneumonia in 3-16% of infants born to women with untreated chlamydial cervical infection at the time of delivery.9-12 Neonatal prophylaxis against gonococcal conjunctivitis routinely performed at birth does not effectively prevent chlamydial conjunctivitis.37-39
Screening and treatment of chlamydia in pregnant women is the best method for preventing neonatal chlamydial disease. All pregnant women should be screened for chlamydia at their first prenatal visit. Pregnant women under 25 and those at increased risk for chlamydia (e.g., women who have a new or more than one sex partner) should be screened again in their third trimester. Pregnant women with chlamydial infection should be retested 3 weeks and 3 months after completion of recommended therapy.40
Who should be tested for chlamydia?
Any sexually active person can be infected with chlamydia. Anyone with genital symptoms such as discharge, burning during urination, unusual sores, or rash should refrain from having sex until they are able to see a health care provider about their symptoms.
Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STD should see a health care provider for evaluation.
Because chlamydia is usually asymptomatic, screening is necessary to identify most infections. Screening programs have been demonstrated to reduce rates of adverse sequelae in women.31,41 CDC recommends yearly chlamydia screening of all sexually active women younger than 25, as well as older women with risk factors such as new or multiple partners, or a sex partner who has a sexually transmitted infection.40 Rectal chlamydia testing can be considered for females based on sexual behaviors and exposure. 40 Pregnant women under 25 or older pregnant women at increased risk for chlamydia (e.g., women who have a new or more than one sex partner) should be screened during their first prenatal visit and again during their third trimester.40 Women diagnosed with chlamydial infection should be retested approximately 3 months after treatment.40 Any woman who is sexually active should discuss her risk factors with a health care provider who can then determine if more frequent screening is necessary.
Routine screening is not recommended for men. However, the screening of sexually active young men should be considered in clinical settings with a high prevalence of chlamydia (e.g., adolescent clinics, correctional facilities, and STD clinics) when resources permit and do not hinder screening efforts in women.40
Sexually active men who have sex with men (MSM) who had insertive intercourse should be screened for urethral chlamydial infection and MSM who had receptive anal intercourse should be screened for rectal infection at least annually; screening for pharyngeal infection is not recommended.. More frequent chlamydia screening at 3-month intervals is indicated for MSM, including those with HIV infection, if risk behaviors persist or if they or their sexual partners have multiple partners.40
At the initial HIV care visit, providers should test all sexually active persons with HIV infection for chlamydia and perform testing at least annually during the course of HIV care. A patient’s health care provider might determine more frequent screening is necessary, based on the patient’s risk factors.42
How is chlamydia diagnosed?
There are a number of diagnostic tests for chlamydia, including nucleic acid amplification tests (NAATs), cell culture, and others. NAATs are the most sensitive tests, and can be performed on easily obtainable specimens such as vaginal swabs (either clinician- or patient-collected) or urine.43
Vaginal swabs, either patient- or clinician-collected, are the optimal specimen to screen for genital chlamydia using NAATs in women; urine is the specimen of choice for men, and is an effective alternative specimen type for women.43 Self-collected vaginal swab specimens perform at least as well as other approved specimens using NAATs.44 In addition, patients may prefer self-collected vaginal swabs or urine-based screening to the more invasive endocervical or urethral swab specimens.45 Adolescent girls may be particularly good candidates for self-collected vaginal swab- or urine-based screening because pelvic exams are not indicated if they are asymptomatic.
NAATs have demonstrated improved sensitivity and specificity compared with culture for the detection of C. trachomatis at rectal and oropharyngeal sites.40 Certain NAAT test platforms have been cleared by FDA for these non-genital sites; and data indicate NAAT performance on self-collected rectal swabs is comparable to clinician-collected rectal swabs. 40
What is the treatment for chlamydia?
Chlamydia can be easily cured with antibiotics. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV-negative.
Persons with chlamydia should abstain from sexual activity for 7 days after single dose antibiotics or until completion of a 7-day course of antibiotics, to prevent spreading the infection to partners. It is important to take all of the medication prescribed to cure chlamydia. Medication for chlamydia should not be shared with anyone. Although medication will cure the infection, it will not repair any permanent damage done by the disease. If a person’s symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated.
Repeat infection with chlamydia is common.49 Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple chlamydial infections increases a woman’s risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy.50,51 Women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated.40
Infants infected with chlamydia may develop ophthalmia neonatorum (conjunctivitis) and/or pneumonia.10 Chlamydial infection in infants can be treated with antibiotics.
What about partners?
If a person has been diagnosed and treated for chlamydia, he or she should tell all recent anal, vaginal, or oral sex partners (all sex partners within 60 days before the onset of symptoms or diagnosis) so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from chlamydia and will also reduce the person’s risk of becoming re-infected. A person with chlamydia and all of his or her sex partners must avoid having sex until they have completed their treatment for chlamydia (i.e., seven days after single dose antibiotics or until completion of a seven-day course of antibiotics) and until they no longer have symptoms. For tips on talking to partners about sex and STD testing, visit www.gytnow.org/talking-to-your-partner/external icon
To help get partners treated quickly, healthcare providers in some states may give infected individuals extra medicine or prescriptions to give to their sex partners. This is called expedited partner therapy or EPT. In published clinical trials comparing EPT to traditional patient referral (i.e., asking the patient to refer their partners in for treatment), EPT was associated with fewer persistent or recurrent chlamydial infections in the index patient, and a larger reported number of partners treated.52 For providers, EPT represents an additional strategy for partner management of persons with chlamydial infection; partners should still be encouraged to seek medical evaluation, regardless of whether they receive EPT. To obtain further information regarding EPT, including the legal status of EPT in a specific area, see the Legal Status of Expedited Partner Therapy.
How can chlamydia be prevented?
Latex male condoms, when used consistently and correctly, can reduce the risk of getting or giving chlamydia.53 The surest way to avoid chlamydia is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Where can I get more information?
Health care providers with STD consultation requests can contact the STD Clinical Consultation Network (STDCCN). This service is provided by the National Network of STD Clinical Prevention Training Centers and operates five days a week. STDCCN is convenient, simple, and free to health care providers and clinicians. More information is available at www.stdccn.orgexternal icon.
Division of STD Prevention (DSTDP)
Centers for Disease Control and Prevention
CDC-INFO Contact Center
TTY: (888) 232-6348
CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail: [email protected]
American Sexual Health Association (ASHA)external icon
P.O. Box 13827
Research Triangle Park, NC 27709-3827
1. O’Farrell N, Morison L, Moodley P, et al. Genital ulcers and concomitant complaints in men attending a sexually transmitted infections clinic: implications for sexually transmitted infections management. Sexually transmitted diseases 2008;35:545-9.
2. White JA. Manifestations and management of lymphogranuloma venereum. Current opinion in infectious diseases 2009;22:57-66.
3. Kreisel KM, Spicknall IH, Gargano JW, Lewis FM, Lewis RM, Markowitz LE, Roberts H, Satcher Johnson A, Song R, St. Cyr SB, Weston EJ, Torrone EA, Weinstock HS. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2018. Sex Transm Dis 2021; in press.
4. CDC. Sexually Transmitted Disease Surveillance, 2019. Atlanta, GA: Department of Health and Human Services; April 2021.
5. Torrone E, Papp J, Weinstock H. Prevalence of Chlamydia trachomatis Genital Infection Among Persons Aged 14–39 Years — United States, 2007–2012. MMWR 2014;63:834-8.
6. Marcus JL, Bernstein KT, Stephens SC, et al. Sentinel surveillance of rectal chlamydia and gonorrhea among males–San Francisco, 2005-2008. Sexually transmitted diseases 2010;37:59-61.
7. Pinsky L, Chiarilli DB, Klausner JD, et al. Rates of asymptomatic nonurethral gonorrhea and chlamydia in a population of university men who have sex with men. Journal of American college health : J of ACH 2012;60:481-4.
8. Park J, Marcus JL, Pandori M, Snell A, Philip SS, Bernstein KT. Sentinel surveillance for pharyngeal chlamydia and gonorrhea among men who have sex with men–San Francisco, 2010. Sexually transmitted diseases 2012;39:482-4.
9. Frommell GT, Rothenberg R, Wang S, McIntosh K. Chlamydial infection of mothers and their infants. The Journal of pediatrics 1979;95:28-32.
10. Hammerschlag MR, Chandler JW, Alexander ER, English M, Koutsky L. Longitudinal studies on chlamydial infections in the first year of life. Pediatric infectious disease 1982;1:395-401.
11. Heggie AD, Lumicao GG, Stuart LA, Gyves MT. Chlamydia trachomatis infection in mothers and infants. A prospective study. American journal of diseases of children (1960) 1981;135:507-11.
12. Schachter J, Grossman M, Sweet RL, Holt J, Jordan C, Bishop E. Prospective study of perinatal transmission of Chlamydia trachomatis. JAMA : the journal of the American Medical Association 1986;255:3374-7.
13. Bell TA, Stamm WE, Wang SP, Kuo CC, Holmes KK, Grayston JT. Chronic Chlamydia trachomatis infections in infants. JAMA : the journal of the American Medical Association 1992;267:400-2.
14. Batteiger BE, Tu W, Ofner S, et al. Repeated Chlamydia trachomatis genital infections in adolescent women. The Journal of infectious diseases 2010;201:42-51.
15. Eaton DK, Kann L, Kinchen S, et al. Youth risk behavior surveillance – United States, 2011. Morbidity and mortality weekly report Surveillance summaries (Washington, DC : 2002) 2012;61:1-162.
16. Kraut-Becher JR, Aral SO. Gap length: an important factor in sexually transmitted disease transmission. Sexually transmitted diseases 2003;30:221-5.
17. Singer A. The uterine cervix from adolescence to the menopause. British journal of obstetrics and gynaecology 1975;82:81-99.
18. Cunningham SD, Kerrigan DL, Jennings JM, Ellen JM. Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents. Perspectives on sexual and reproductive health 2009;41:225-30.
19. Elliott BA, Larson JT. Adolescents in mid-sized and rural communities: foregone care, perceived barriers, and risk factors. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2004;35:303-9.
20. Tilson EC, Sanchez V, Ford CL, et al. Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions. BMC public health 2004;4:21.
21. Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: the case for screening. Preventive medicine 2003;36:502-9.
22. Korenromp EL, Sudaryo MK, de Vlas SJ, et al. What proportion of episodes of gonorrhoea and chlamydia becomes symptomatic? International journal of STD & AIDS 2002;13:91-101.
23. Wiesenfeld HC, Sweet RL, Ness RB, Krohn MA, Amortegui AJ, Hillier SL. Comparison of acute and subclinical pelvic inflammatory disease. Sexually transmitted diseases 2005;32:400-5.
24. Berger RE, Alexander ER, Monda GD, Ansell J, McCormick G, Holmes KK. Chlamydia trachomatis as a cause of acute “idiopathic” epididymitis. The New England journal of medicine 1978;298:301-4.
25. Barry PM, Kent CK, Philip SS, Klausner JD. Results of a program to test women for rectal chlamydia and gonorrhea. Obstetrics and gynecology 2010;115:753-9.
26. Jones RB, Rabinovitch RA, Katz BP, et al. Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Annals of internal medicine 1985;102:757-62.
27. Quinn TC, Goodell SE, Mkrtichian E, et al. Chlamydia trachomatis proctitis. The New England journal of medicine 1981;305:195-200.
28. Thompson CI, MacAulay AJ, Smith IW. Chlamydia trachomatis infections in the female rectums. Genitourinary medicine 1989;65:269-73.
29. Kalayoglu MV. Ocular chlamydial infections: pathogenesis and emerging treatment strategies. Current drug targets Infectious disorders 2002;2:85-91.
30. Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after Chlamydia trachomatis genital infection in women. The Journal of infectious diseases 2010;201 Suppl 2:S134-55.
31. Oakeshott P, Kerry S, Aghaizu A, et al. Randomized controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. BMJ (Clinical research ed) 2010;340:c1642.
32. Cates W, Jr., Wasserheit JN. Genital chlamydial infections: epidemiology and reproductive sequelae. American journal of obstetrics and gynecology 1991;164:1771-81.
33. Westrom L, Joesoef R, Reynolds G, Hagdu A, Thompson SE. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sexually transmitted diseases 1992;19:185-92.
34. Rours GI, Duijts L, Moll HA, et al. Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study. European journal of epidemiology 2011;26:493-502.
35. Carter JD, Inman RD. Chlamydia-induced reactive arthritis: hidden in plain sight? Best practice & research Clinical rheumatology 2011;25:359-74.
36. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually transmitted infections 1999;75:3-17.
37. Bell TA, Sandstrom KI, Gravett MG, et al. Comparison of ophthalmic silver nitrate solution and erythromycin ointment for prevention of natally acquired Chlamydia trachomatis. Sexually transmitted diseases 1987;14:195-200.
38. Chen JY. Prophylaxis of ophthalmia neonatorum: comparison of silver nitrate, tetracycline, erythromycin and no prophylaxis. The Pediatric infectious disease journal 1992;11:1026-30.
39. Isenberg SJ, Apt L, Wood M. A controlled trial of povidone-iodine as prophylaxis against ophthalmia neonatorum. The New England journal of medicine 1995;332:562-6.
40. Workowski, KA, Bachmann, LH, Chang, PA, et. al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70(No. 4): 1-187.
41. Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. The New England journal of medicine 1996;334:1362-6.
42. CDC. Incorporating HIV prevention into the medical care of persons living with HIV. Recommendations of CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recommendations and reports : Morbidity and mortality weekly report Recommendations and reports / Centers for Disease Control 2003;52:1-24.
43. APHL. Laboratory Diagnostic Testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Expert Consultation Meeting Summary Report. January 13-15, 2009. Atlanta, GA.
44. Schachter J, Chernesky MA, Willis DE, et al. Vaginal swabs are the specimens of choice when screening for Chlamydia trachomatis and Neisseria gonorrhoeae: results from a multicenter evaluation of the APTIMA assays for both infections. Sexually transmitted diseases 2005;32:725-8.
45. Doshi JS, Power J, Allen E. Acceptability of chlamydia screening using self-taken vaginal swabs. International journal of STD & AIDS 2008;19:507-9.
46. Bachmann LH, Johnson RE, Cheng H, et al. Nucleic acid amplification tests for diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis rectal infections. Journal of clinical microbiology 2010;48:1827-32.
47. Mimiaga MJ, Mayer KH, Reisner SL, et al. Asymptomatic gonorrhea and chlamydial infections detected by nucleic acid amplification tests among Boston area men who have sex with men. Sexually transmitted diseases 2008;35:495-8.
48. Schachter J, Moncada J, Liska S, Shayevich C, Klausner JD. Nucleic acid amplification tests in the diagnosis of chlamydial and gonococcal infections of the oropharynx and rectum in men who have sex with men. Sexually transmitted diseases 2008;35:637-42.
49. Hosenfeld CB, Workowski KA, Berman S, et al. Repeat infection with Chlamydia and gonorrhea among females: a systematic review of the literature. Sexually transmitted diseases 2009;36:478-89.
50. Hillis SD, Owens LM, Marchbanks PA, Amsterdam LF, Mac Kenzie WR. Recurrent chlamydial infections increase the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease. American journal of obstetrics and gynecology 1997;176:103-7.
51. Bakken IJ, Skjeldestad FE, Lydersen S, Nordbo SA. Births and ectopic pregnancies in a large cohort of women tested for Chlamydia trachomatis. Sexually transmitted diseases 2007;34:739-43.
52. Trelle S, Shang A, Nartey L, Cassell JA, Low N. Improved effectiveness of partner notification for patients with sexually transmitted infections: systematic review. BMJ (Clinical research ed) 2007;334:354.
53. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization 2004;82:454-61.
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What’s This Rash? Pictures of STDs and STIs
If you’re worried that you or your partner may have contracted a sexually transmitted infection (STI), read on for the information you need to recognize the symptoms.
Some STIs have no symptoms or only mild ones. If you’re concerned but don’t see symptoms identified here, check with your doctor to discuss your STI risks and appropriate testing.
Is this discharge normal?
Discharge from the vagina
Small amounts of discharge, especially from the vagina, is often normal.
But some sexually transmitted conditions can cause discharge from the genitals. Depending on the condition, the color, texture, and volume of the discharge may vary.
Though many people with chlamydia , this condition sometimes produces a mucus- or pus-like vaginal discharge.
With trichomoniasis, or “trich,” the vaginal discharge looks frothy or foamy and has a strong, unpleasant odor.
A yellowish or yellow-green vaginal discharge can be a symptom of gonorrhea, although most people who contract it will have no symptoms at all.
Discharge from the penis
Some conditions can cause discharge or even bleeding from the penis.
Gonorrhea produces a white, yellow, or greenish discharge from the penis.
Chlamydia symptoms may include a pus-like discharge from the penis, or the fluid may be watery or milky-looking.
Trichomoniasis doesn’t usually show symptoms, but it can cause discharge from the penis in some cases.
Blisters, bumps, or warts
HPV and genital warts
With the human papillomavirus (HPV), the body often naturally clears the virus. However, the body can’t remove all strains of HPV.
Some strains of HPV cause genital warts. The warts can vary in size and appearance. They can look:
All genital warts need medical attention. Your doctor will determine whether the warts are caused by the strains of HPV that may cause anogenital cancer.
Severe HPV may cause several warts in the genital or anal areas.
Blisters on or around the genitals, rectum, or mouth may signal an outbreak of herpes simplex virus. These blisters break and produce painful sores, which can take several weeks to heal.
Herpes blisters are painful. There may be pain while urinating if the herpes blisters are close to the urethra.
It’s important to remember that herpes can still spread from one person to another, even if there are no visible blisters.
Granuloma inguinale usually starts with a nodule that erodes into an ulcer. The ulcer is usually painful.
A single, round, firm, painless sore is the first symptom of syphilis, a bacterial STI. The sore can appear wherever the bacteria entered the body, including the:
- external genitals
One sore appears at first, but multiple sores may appear later. The sores are generally painless and often go unnoticed.
Secondary stage syphilis rash and sores
Without treatment, syphilis progresses to a secondary stage. Rashes or sores in mucous membranes of the mouth, vagina, or anus occur during this stage.
The rash may look red or brown, and have a flat or velvety appearance. It usually doesn’t itch.
The rash can also appear on the palms or soles of the feet, or as a general rash on the body. Large gray or white lesions may appear in moist areas in the groin, under the arms, or in the mouth.
Rectal STI symptoms
Chlamydia can spread to the rectum. In these cases, symptoms may include:
- prolonged rectal pain
- painful bowel movements
- rectal bleeding
Gonorrhea rectal symptoms include:
- pain and itching in the anus
- painful bowel movements
Pain, pressure, or burning during or after urination, or more frequent urination, may be a symptom of chlamydia, trichomoniasis, or gonorrhea in people with a vagina.
Because gonorrhea in people with a vagina often produces no symptoms or only mild symptoms that can be confused with a bladder infection, it’s important not to ignore painful urination.
In people with a penis, either trichomoniasis or gonorrhea may cause painful urination. Pain after ejaculation may also occur in those who contract trichomoniasis.
Many STIs can be treated and cured, especially if diagnosed early.
If you’re experiencing any of the above symptoms, see a healthcare provider to get a diagnosis and appropriate treatment.