How to Prevent, Detect and Treat STIs
Sexually transmitted diseases (STD) have no limitations. Whether you’re single, married or returning to the midlife dating game, STDs are caused by infections that are passed from one person to another during sexual contact. These infections often don’t cause symptoms, and medically, infections are only called diseases when they cause symptoms. That’s why STDs are also called “sexually transmitted infections (STI).”
Northwestern Medicine gynecologist and sexual medicine expert Lauren Streicher, MD, answers the most common questions about STIs and how you can protect yourself.
How common are STIs?
Millions of people in the United States have STIs, but most cases are not reported. Many people have no symptoms or are unaware that their symptoms are the result of an STI. Your partner may be infected and not know it. Post-menopause women are at particular risk since vaginal tissue is thinner and more likely to tear during intercourse, allowing infection an easy portal. That’s why it’s important for all men and women to practice “safe sex,” even if pregnancy is not an issue.
What is safe sex?
There is no such thing as 100% safe sex, because any sexual activity or intimate contact (not just intercourse) can result in an STI. “Safer sex” lowers the chances of transmitting an STI from an infected partner to a non-infected partner.
male condom can prevent infections that exist on the skin of the penis or in the semen, but it doesn’t protect you against certain STIs like HPV or herpes viruses that may be present on genital skin, so intercourse is not necessary to transmit them. Some people feel that a condom interferes with sensation, and some men may not be able to maintain an erection when they use a condom.
Another solution is the Reality Female Condom (FC2), a non-latex, very soft, thin sheath that lines the vagina. It not only covers the cervix and vaginal walls, but also shields the vulva (the genital skin outside the vagina). An FC2 condom can be bought over-the-counter, and prevents both infections and pregnancy (and is sometimes covered by insurance). No special fitting is needed because one size fits all. Since STIs are more easily passed from man to woman than from woman to man, female condoms give women added protection. If exposed, a woman is twice as likely as a man to contract hepatitis B, gonorrhea or HIV, and women are less likely to have symptoms than men, which means diagnosis is often delayed or missed.
How quickly after unprotected sex can symptoms of an STI occur?
There are more than 30 STIs, and each one has its own set of unique symptoms. For some STIs, there are no symptoms at all. If you are concerned about someone you’ve been exposed to sexually, you need to request to be tested, because STI tests not routinely performed during a Pap test or annual exam. Be sure to share your symptoms, if any, such as abnormal bleeding, abdominal aches or unexplained discharge, as your symptoms may help determine the type of screening(s) needed. Your physician will not be shocked and does not require you to divulge the details of why you are requesting screening.
Are STIs curable?
Some STIs are treatable, and while certain infections can't be eliminated, they can be controlled.
How important is it to see a gynecologist, or can I just see my primary care physician?
It’s not necessarily important which specialist you see, but it is important that you are being evaluated by a health care provider who is an expert in the prevention, detection and treatment of STIs.
How often should I get tested if I don’t have any symptoms?
Many people won’t have symptoms, so any time you have a new partner, you should request a screening. Also, it doesn’t matter if you are single or married, you should be offered screening at least once a year. Testing is not automatic so don’t wait for your physician to bring it up.
Is STI testing invasive?
Most testing is not any more invasive than a cervical swab during a routine gynecologic exam. Depending on the type of STI, your physician may not even need to do a physical exam but instead test your urine or blood.