Would you believe the most common STIs often cause no symptoms? It’s true! And the impact on women is significant — compared to men, women lose more quality-adjusted life years due to infections from chlamydia, gonorrhea, and trich. These infections can have severe health consequences if left untreated. And because these STIs can be asymptomatic, it’s possible to have one in a monogamous relationship. That makes it more crucial than ever to stay informed and vigilant about STIs.
“The most dangerous STIs are often the quietest,” says Richard Hopley, M.D., PathAdvantage associate medical director. “Chlamydia and gonorrhea can cause long-term harm without a single symptom. Regular screeningis essential, especially since many STIs don’t show symptoms. Early detection can prevent infertility and serious complications.”
Asymptomatic STIs and How to Prevent Them:
Learning about these STIs will help you take preventive measures to protect your health. Don’t let these sneaky asymptomatic STIs catch you off guard. Check out our guide to these invisible STIs below:
What is Chlamydia?
The most commonly reported STI in the U.S., chlamydia, is the result of the bacteria Chlamydia trachomatis passed between sexual partners during vaginal, oral, and anal sex. Likewise, the infection can show up in the mouth, the urethra, the rectum, the cervix, and the uterus. The infection typically doesn’t cause any symptoms, but if they do occur, they include:
- Yellow discharge from the vagina or urethra
- Frequent or painful urination
- Vaginal bleeding between periods
- Rectal bleeding, discharge or pain
You can get tested for chlamydia by your doctor, who will either take a urine sample or a painless swab sample that can be collected from the vagina, rectum, penis, or throat. Treatment consists of you and any partners within the past two months receiving a course of antibiotics. Since the infection can still be passed to a partner during treatment, you should avoid sexual contact until you fully finish the antibiotic. You should also get retested three to four months later to make sure the infection is gone.
Left untreated, chlamydia can cause serious complications, especially for women, including pelvic inflammatory disease (PID), infertility, and ectopic pregnancy.
What is Gonorrhea?
Gonorrhea is the second most common STI in the U.S. — and is frequently asymptomatic. While it often co-occurs with chlamydia it’s caused by a different bacterium, Neisseria gonorrhoeae, that is also passed from partner to partner via sex. Any symptoms that may occur can look very similar to chlamydia’s occasional symptoms and include:
- Yellow discharge from the vagina or urethra
- Frequent or painful urination
- Vaginal bleeding between periods
- Itching and soreness
- Painful defecation
- Rectal bleeding, discharge, or pain
Though the two STIs are diagnosed similarly, they are treated differently. With gonorrhea, your doctor will typically give you an antibiotic injection as well as giving you an oral antibiotic. While both STIs are 100 percent curable, gonorrhea is more stubborn due to antibiotic resistance. As with chlamydia, refrain from having sex until you finish your medication.
Just like chlamydia, untreated gonorrhea can cause PID and a life-threatening infection called disseminated gonococcal infection, which causes fever, chills, skin sores, and pain in the wrists, fingers, knees, and toes.
What is Syphilis?
Syphilis is another STI caused by a bacterium and according to the CDC, syphilis infection rates increased 80 percent from 2018 to 2022. It causes sores on the vulva, vagina, anus, and penis that seem to fade without treatment. Syphilis can also spread by coming in contact with a partner’s rash that appears in later stages of the STI. Syphilis symptoms occur in stages:
- The primary stage includes a chancre that goes away without treatment in three to six weeks, which can seem deceptive since it disappears even though the infection is still active.
- During the secondary stage, as the chancre is healing or gone, a rash appears on the palms of the hands and soles of the feet. Flat wart-like sores may appear on the vulva. You may also have flu-like symptoms.
- The last stage, latent infection happens if syphilis goes untreated. Sores, warts, and the rash may disappear, but the infection is still inside the body and can cause serious health problems.
To test for syphilis, your doctor will do bloodwork. Most people aren’t regularly tested for syphilis, but pregnant women should be tested multiple times throughout pregnancy since they can pass the disease onto the baby, which can be fatal. When treated with antibiotics early, you can prevent long-term complications from syphilis. The longer you’ve had syphilis, however, the longer you may need to take antibiotics. You will need to be retested periodically to make sure the infection is clearing. You must avoid having sex during treatment, and you will likely also be tested for HIV since the sores/chancres associated with syphilis increase your odds of contracting HIV.
Untreated latent syphilis is a very serious disease that can cause heart problems, neurological problems, brain damage, blindness, paralysis, and death.
How to Prevent Asymptomatic STIs and What to do if you Notice Symptoms
Obviously, you should get tested regularly. Your clinician will be able to provide treatment if you do have any infections. Of course, tell your partner so they can also get treated and reduce the risk of infection.
It is important to test for STIs regularly, even if you are currently single or in a committed relationship. Also, since these infections can be asymptomatic and last for years, it’s entirely possible a partner may not know they have an STI. Just as important is retesting for STIs after a course of treatment to be sure the infection was effectively eradicated.
Now that you know about these asymptomatic STIs, you should guard against getting one. Ask your partners about their sexual history, any past infections, and recent testing. Get tested before becoming sexually active with any new partners. Correctly use a condom every time you have sex. And see your doctor right away if you have any STI symptoms.
Sources
Centers for Disease Control and Prevention. Sexually Transmitted Infections Surveillance, 2022. www.cdc.gov. Published January 29, 2024. https://www.cdc.gov/std/statistics/2022/default.htm
Chlamydia, Gonorrhea, and Syphilis. www.acog.org. Published April 2024. https://www.acog.org/womens-health/faqs/chlamydia-gonorrhea-and-syphilis
Get Tested for Chlamydia and Gonorrhea – MyHealthfinder | odphp.health.gov. Health.gov. Published October 2023. https://odphp.health.gov/myhealthfinder/health-conditions/hiv-and-other-stds/get-tested-chlamydia-and-gonorrhea
Li Y, You S, Lee K, et al. The Estimated Lifetime Quality-Adjusted Life-Years Lost Due to Chlamydia, Gonorrhea, and Trichomoniasis in the United States in 2018. The Journal of Infectious Diseases. Published online February 18, 2023. doi:https://doi.org/10.1093/infdis/jiad047
