Sexually transmitted diseases (STDs) are infections passed from one person to another through sexual contact. Many STDs do not show symptoms, meaning it’s possible to be infected and not know it. This makes STDs dangerous since they can be unknowingly spread to sexual partners.
Common STDs with No Symptoms
Here are some of the most common STDs that often do not show obvious symptoms:
- Chlamydia – Caused by the bacteria Chlamydia trachomatis. It can infect the cervix, urethra, throat, and rectum.
- Gonorrhea – Caused by the bacteria Neisseria gonorrhoeae. It can infect the cervix, urethra, throat, and rectum.
- Human Papillomavirus (HPV) – There are over 100 strains of this virus. Some cause genital warts while others lead to cervical cancer.
- Hepatitis B – Caused by the hepatitis B virus (HBV). It infects the liver leading to severe liver damage over time.
- Syphilis – Caused by the bacteria Treponema pallidum. It progresses in stages and can infect many parts of the body.
- HIV – Caused by the human immunodeficiency virus (HIV). It attacks the immune system leading to acquired immunodeficiency syndrome (AIDS).
- Herpes – Caused by the herpes simplex virus (HSV). Comes in two strains, HSV-1 and HSV-2, and causes periodic blisters on the mouth or genitals.
- Trichomoniasis – Caused by the protozoan parasite Trichomonas vaginalis. It infects the genital tract leading to painful urination and discharge.
Let’s go through some of these STDs in more detail:
Chlamydia
Chlamydia is one of the most common STDs. The CDC estimates that in 2018 there were 1.7 million cases in the United States. It is caused by Chlamydia trachomatis bacteria that infect mucous membranes including the:
- Cervix (opening of the uterus) in women
- Urethra (urine canal) in both women and men
- Rectum
- Throat
Chlamydia often does not cause any symptoms, especially in women. When symptoms do appear, they may show up between 1 to 3 weeks after exposure.
Some potential symptoms include:
- Burning feeling during urination
- Unusual discharge from the penis or vagina
- Pain in the lower abdomen
- Bleeding between periods
- Itching or irritation around the genitals
Without treatment, chlamydia can lead to long-term complications. In women this includes pelvic inflammatory disease, infertility, and ectopic pregnancy. In men, it can cause epididymitis which is inflammation of the tubes carrying sperm.
Testing and Treatment
Chlamydia is easily cured with antibiotic treatment. A single dose of azithromycin or taking doxycycline for 7 days are common treatments.
Testing is done through urine sample or a swab from the infected area. Annual chlamydia screening is recommended for sexually active women under 25 and older women with risk factors.
Gonorrhea
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. In 2018, the CDC estimated 583,405 cases in the U.S. Like chlamydia, it often does not show symptoms. When symptoms do appear, they show up between 2 to 14 days after infection.
Some potential symptoms include:
- Thick, cloudy or bloody discharge from the penis or vagina
- Pain or burning sensation when urinating
- Swollen or painful testicles
- Painful bowel movements
- Bleeding between periods in women
If left untreated, gonorrhea can cause epididymitis and pelvic inflammatory disease. It can also spread to the blood and joints. This condition is called disseminated gonococcal infection (DGI).
Testing and Treatment
Like chlamydia, gonorrhea is treated and cured with antibiotics. The CDC recommends a combination of ceftriaxone and azithromycin as the preferred gonorrhea treatment regimen.
Testing involves a urine sample or swab from the infected area. The CDC recommends annual screening for sexually active women under 25 and older women at increased risk.
HIV
Human immunodeficiency virus (HIV) damages the immune system leading to acquired immunodeficiency syndrome (AIDS). The virus spreads through bodily fluids including semen, vaginal fluids, blood, and breast milk.
Many people have no symptoms for years after first being infected with HIV. This early stage of infection is called acute HIV infection. Possible symptoms at this stage include:
- Fever
- Chills
- Rash
- Night sweats
- Muscle aches
- Sore throat
- Swollen lymph nodes
These symptoms may last anywhere from a few days to several weeks. After this, the virus moves into a stage called clinical latency with no obvious symptoms. This can last many years until it progresses to AIDS when severe symptoms develop.
Testing and Treatment
There is currently no cure for HIV, but treatment with antiviral drugs can control the virus. This allows people with HIV to live long and healthy lives.
HIV testing is done through a blood test that detects antibodies produced by the immune system in response to the virus. The CDC recommends testing for adults ages 13 to 64 at least once as a routine part of medical care.
Herpes
Herpes refers to two strains of the herpes simplex virus (HSV):
- HSV-1 – Primarily causes oral herpes with cold sores and fever blisters on the mouth and lips
- HSV-2 – Primarily causes genital herpes with sores on the genitals and surrounding areas
However, both strains can infect the genital and oral areas. Many people carry HSV-1 or HSV-2 but never show symptoms. When symptoms do appear, the first outbreak is generally the most severe occurring within 2-20 days after infection.
Common symptoms of a primary herpes outbreak include:
- Tingling, burning, or itching before blisters appear
- Small, painful blisters on mouth, genitals, or other areas
- Ulcers after blisters break
- Fever
- Muscle aches
- Swollen lymph nodes
After the initial outbreak, HSV enters a latent phase where it becomes dormant in nerve cells. Periodic reactivations can occur causing localized outbreaks in the same area as the initial infection. However, recurrent outbreaks tend to be less severe.
Testing and Treatment
There is no cure for herpes, but antiviral medications can help control outbreaks. Daily suppressive therapy can help prevent reoccurring outbreaks.
Testing can be done through a blood test, culture of sore fluid, or direct fluorescent antibody (DFA). Since many people carry HSV without symptoms, routine screening is not recommended.
HPV
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Nearly all sexually active adults will get infected at some point. There are over 100 strains of HPV grouped into low and high risk types:
- Low-risk HPV – Types 6 and 11 cause 90% of genital warts cases.
- High-risk HPV – Types 16 and 18 cause 70% of cervical cancer cases.
In most cases, HPV resolves spontaneously within 1 to 2 years and does not cause health problems. Persistent infection with high-risk HPV can eventually lead to cancer over many years.
HPV typically has no signs or symptoms. Some people develop visible genital warts, but even those infected with cancer-causing strains may have no outward changes.
Testing and Treatment
Doctors can visually detect genital warts. Precancerous changes to cells caused by high-risk HPV can be detected through Pap tests and HPV screening.
There is no cure for HPV. Genital warts can be removed through topical medications, cryotherapy, laser therapy, or surgery. HPV vaccines help prevent infection from the most cancer-causing strains.
Hepatitis B
Hepatitis B is caused by the hepatitis B virus (HBV) that infects liver cells. Acute infection can range from mild illness to severe sickness requiring hospitalization.
Adults with acute hepatitis B often have flu-like symptoms including:
- Fever
- Fatigue
- Loss of appetite
- Nausea
- Vomiting
- Abdominal pain
- Grey-colored stools
- Joint pain
- Jaundice (yellow skin)
Many adults have no symptoms during the initial infection. Asymptomatic acute infection occurs in 30-50% of adults.
Chronic hepatitis B develops when the virus remains in the body. This occurs in up to 90% of infant infections but only 5% of adult infections. Still, many patients have no symptoms for years until liver damage is advanced.
Testing and Treatment
Blood tests detect antigens and antibodies to help diagnose hepatitis B. Liver enzyme tests can also help assess liver damage.
Antiviral medications can help slow progression of chronic hepatitis B. However, liver damage is often irreversible. Vaccination helps prevent hepatitis B infection.
Trichomoniasis
Trichomoniasis is a common protozoan STD caused by the parasite Trichomonas vaginalis. It infects the urogenital tract of men and women.
Many infected men show no symptoms. When present, signs and symptoms may appear within 5 to 28 days and include:
- Thin, white, greenish or yellowish vaginal discharge (women)
- Discharge from the penis (men)
- Strong vaginal odor (women)
- Itching, redness, soreness of the genitals
- Painful urination
- Need to urinate more frequently
Infected women often develop symptoms while men remain asymptomatic. However, infected men can still spread it to sexual partners.
Testing and Treatment
Trichomoniasis testing involves examining genital discharge under a microscope. Certain antibiotics can cure trichomoniasis.
Syphilis
Syphilis is caused by the bacteria Treponema pallidum. It progresses through primary, secondary, latent, and tertiary stages with different sets of symptoms.
During primary syphilis, a painless sore called a chancre forms at the infection site. It appears 10-90 days after infection and lasts 3 to 6 weeks. Sores mainly occur on the genitals, rectum, tongue, or lips. Swelling of lymph nodes near the sore may occur.
If untreated, secondary syphilis occurs 6 weeks to 6 months after the chancre forms:
- Rash on palms of hands and soles of feet
- Small skin growths on vulva, vagina, cervix, penis, scrotum, anus
- White patches inside mouth
- Hair loss
- Headaches, joint pain, fatigue
- Wart-like lesions around genitals or anus
After secondary syphilis, the infection enters a hidden latent phase. Tertiary syphilis occurs 10–30 years after infection setting in and can cause severe medical problems.
Testing and Treatment
Syphilis testing is done using blood tests. It can be effectively treated with antibiotics like penicillin. However, treatment cannot undo damage already done.
How to Prevent STDs
The most effective ways to avoid STDs are:
- Get vaccinated – Immunizations exist to prevent hepatitis B and HPV.
- Use condoms – Correctly using male or female condoms during sex reduces your risk.
- Limit sexual partners – More partners means greater risk of exposure.
- Get tested – Know your status through regular STD testing.
Early diagnosis through testing gives you the chance to receive treatment before severe complications develop. It also allows you to take measures such as abstaining from sex during treatment to avoid spreading the infection.
When to See a Doctor
See a doctor or visit an STD clinic if you have any of the following:
- Discharge, sores, bumps, rashes, or itching around genital or anal areas
- Painful urination or bowel movements
- Unexplained pelvic pain
- Burning sensation during urination
- Abnormal discharge from penis, vagina, or rectum
- Painful sexual intercourse
- Sore throat with enlarged lymph nodes in neck
- Flu-like symptoms following sexual contact
Schedule an appointment right away if:
- You or your partner was diagnosed with an STD
- You change sexual partners frequently
- You engage in unprotected sex
Getting tested is crucial even if you have no symptoms. You cannot rely on signs and symptoms alone to know if you have an STD or not.
Conclusion
Many common STDs frequently do not produce obvious symptoms, especially during the initial infection. However, lack of symptoms does not mean lack of harm. Untreated STDs can lead to serious complications even if you feel perfectly fine.
The most prevalent symptomless STDs include chlamydia, gonorrhea, HIV, herpes, HPV, hepatitis B, trichomoniasis, and syphilis during its latent phase. The absence of symptoms makes it easier to unknowingly spread these infections to sexual partners.
Protect yourself by using condoms, limiting sexual partners, getting vaccinated, and seeking routine STD screening. Pay attention to any unusual symptoms like discharge, sores, or burning urination. Seek immediate testing and treatment if you suspect you were exposed or have symptoms.
Early detection and treatment of STDs, regardless of symptoms, gives you the best chance to avoid potentially permanent effects on your reproductive health and overall well-being.