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23 Causes for STIs in Women - Low Risk to High
A comprehensive guide to STIs and STDs in women.
Posted on September 26, 2017 by Team Research
When Should I See a Doctor?
Low Risk Causes for STIs
Medium Risk Causes for STIs
High Risk Causes for STIs
According to the Centers for Disease Control and Prevention, there are nearly 110 million Americans living with an STI at any given time. Approximately 60 million of these infections are in women1.
As a woman, your risk for contracting an STI is statistically higher than that of a man. In this guide, we’ll explain the causes of the most common STIs among women, treatments, and most important, the preventative actions you can take to protect you and your partner.
The following STIs are broken down into five categories, based on their treatment.
- Low risk: Easily managed with over-the-counter (OTC) medications
- Low-medium risk: Usually managed as an outpatient by your doctor with prescription medication
- Medium risk: May require an ED visit or hospitalization, prescription medication usually needed
- Medium-high risk: Hospitalization needed, usually not life threatening but could be
- High risk: Life threatening and death is possible, Intensive Care Unit (ICU) care often needed
When Should I See a Doctor?
All STIs should be properly diagnosed by a medical professional. Make a general appointment with your doctor if:
- You’re sexually active or 21 years of age, whichever comes first
- You’re planning on engaging in sexual acts with a new partner
- You believe you might have been exposed to an STI
You should seek medical attention immediately if:
- You believe you have been exposed to an STI
- You notice signs or symptoms of an STI
While some STIs are treatable, others are incurable and can have serious and possibly life-threatening consequences that can be better managed with early detection and treatment. Always take a proactive approach when it comes to your sexual health.
Let’s discuss the most common STIs in women. Knowledge is the first step of prevention.
Low Risk Causes for STIs
Low risk: Easily managed with over-the-counter (OTC) medications
1. Candidiasis of Skin
Candidiasis is commonly known as a yeast infection. It is caused by a fungus that is naturally present in the vagina, but at times the yeast can overgrow. Symptoms of candidiasis include vaginal itching, vaginal burning, a thick, white and milky discharge, and discomfort during urination and intercourse. Small bumps that might remind you of genital pimples can also develop. These yeast infection bumps are harmless.
The presence of candida can increase due to wearing tight clothing, warm weather, stress, taking antibiotics, pregnancy, diabetes, and birth control pills. Developing a yeast infection after sex is also possible. Developing a yeast infection during pregnancy is common and, in fact, this is the condition that arises that often alerts women that they could possibly be pregnant it is so common.
Though not considered dangerous in most cases, a yeast infection can be uncomfortable. Over the counter antifungal creams and suppositories can help with discomfort but might not always heal the infection.
If you believe you have candidiasis and cannot alleviate the discomfort with available medication, schedule a doctor’s appointment to discuss other options. You may have to take prescribed antibiotics or suppositories to completely rid the body of the infection.
2. Epstein-Barr Virus (EBV)
Epstein-Barr Virus, or EBV, is commonly known as the “kissing disease” or mononucelosis/mono. EBV is believed to be sexually transmitted, but is more commonly passed between individuals through kissing or sharing cups or eating utensils.
EBV symptoms resemble those of the flu or cold combined with extreme exhaustion. Completing a single common task, like showering or taking the dog for a walk, can be nearly impossible.
Treatment focuses on getting enough rest, a high intake of fluids, and over the counter pain medication for discomfort. Symptoms can last between a week and several weeks, though in severe cases, several years. EBV is a herpes virus, which means it remains dormant in your system for the rest of your life. It is possible to pass the virus to someone else, even when you aren’t displaying symptoms 2.
3. Molluscum contagiosum
Caused by a virus, molluscum contagiosum causes wart-like skin lesions that are typically easily recognizable because they have a belly-button like appearance. The virus can be transmitted sexually but non-sexual skin-to-skin contact can spread it as well. Symptoms typically appear within three months of infection in the form of small, round growths with indentations in the middle.
For relatively health individuals, there are no other symptoms but those with compromised immune systems can experience health complications. Treatment often involves a chemical application, laser procedures, or topical medications. Sexual activity should be avoided until the lesions are cleared.
Usually managed as an outpatient by your doctor with prescription medication
4. Bacterial vaginosis
Bacterial vaginosis, or BV, is an infection that occurs in the vagina because of a bacterial imbalance. Symptoms include localized pain, intense itching, and a foul-smelling discharge, and/or a fish-like odor. However, it is possible to have bacterial vaginosis and have no symptoms.
Bacterial vaginosis can be caused by several events. Douching can throw off the balance of good and bad vaginal bacteria along with having multiple sex partners or smoking cigarettes. The infection can be detected with a culture sample. The presence of clue cells, or unusual cells in the vagina, signals a BV diagnosis. BV treatment over the counter treatments are available and usually involve antibiotics or suppositories.
If properly treated, bacterial vaginosis isn’t considered dangerous. But if left untreated, the risk of contracting an STI increases. Pregnant women may also experience complications related to their pregnancy.
Trichomoniasis, more commonly known as trich (pronounced like “trick”) is caused by the spread of protozoan organisms during sexual contact. It is one of the most common STIs in young females, but also curable.
Nearly half of discovered cases of trichomoniasis are asymptomatic but for those who do experience symptoms, vaginal discharge, spotting, itching, an increase in urination, and pain while urinating are the most common signs of infection. Upon visual examination, a strawberry cervix is a common sign of infection.
Even if the symptoms disappear on their own, treatment is still required to eliminate the protozoan organisms, which can alter vaginal pH and lead to other infections and a higher risk of STI contractions. A single dose of antibiotic medication can cure trichomoniasis.
Oral herpes is the common name for HSV-1. It is a viral STI that results in fever blisters or cold sores on the mouth. The virus is most commonly spread through kissing or sharing drinks but can also be contracted when performing oral sex on an individual with genital herpes.
There is no way to eliminate the herpes virus from the body, but after the initial outbreak, an infected individual can go months or years without symptoms.
HSV-2 is commonly referred to as genital herpes. It’s a viral STI that manifests as lesions or sores in the genital region, upper thighs, or anus. The STI can be contracted through semen, vaginal fluid, visible herpes sores, or saliva.
The initial outbreak is typically the most severe. If you’re wondering, “What does herpes look like,” you can ask your doctor for accurate visual data as pictures on the Internet aren’t always accurate.
Once the genital sores scab and heal, the virus remains in the body but can remain dormant for months or years. The virus is more likely to be spread during outbreaks but can spread when no symptoms are present. Prescribed medication can lessen the number of outbreaks you experience and their severity.
8. Human Papillomavirus (HPV)
There are more than 100 variations of the Human Papillomavirus, or HPV 3. Being infected with HPV is common and in the majority of cases do not lead to serious side effects. But there are strains that can cause genital warts or cancer.
For most cases, there are no symptoms. The virus can remain dormant for years and come to life during periods of stress. Genital warts are described as small, fleshy raised bumps that are either smooth or cauliflower-like in appearance. Seeing pictures of genital warts can help you diagnose your own (you still need to see a doctor though). They can develop anywhere in the genital region, including the thighs and anus.
The warts can be treated but they’re likely to reappear. There is no way to eliminate the virus from the body; however, there have been cases of sporadic elimination. Yearly Pap smears can indicate changes related to HPV, which has been linked to cervical cancer.
There is an HPV vaccine available that targets four common strains associated with warts and cancer. It can be received by both males and females between ages 9 and 26 years of age.
9. Pubic lice
Pubic lice are small bugs that live on pubic hair. They can be seen by the naked eye and cause severe itching. Pubic lice can be transferred during sexual contact, even when condoms are used. They can also be spread by immediately sharing towels or clothing used by an infected person.
Treatment for public lice involves using a topical cream to kill the lice and eliminating all sources of possible lice by treating bedding and clothing. Sexual contact should be avoided until the pubic area has been professionally evaluated.
Scabies is an infection caused by a mite. Unlike pubic lice, the parasites are not viewable with the naked eye but can be seen with a magnifying glass. They cause itching in not just the genital area but also the hands, legs, torso, and arms, depending on how far the infection has spread.
In most infected people, the itching intensifies during the evening. A topical treatment is available, which takes about a week to eliminate the infection. There is also a treatment in the form of a pill but it comes with the risk of side effects. During treatment, all bedding and infected clothing should be treated as well.
11. Mycoplasma hominis
This STI is often confused with gonorrhea and chlamydia and misdiagnosed. Symptoms include vaginal discharge, burning during urination, pain during intercourse, and vaginal itching. But most with the STI don’t experience symptoms at all.
If left untreated, this infection can cause urethritis and increase the risk for pelvic inflammatory disease. Antibiotics can eliminate the infection.
Ureaplasma is considered highly contagious and unfortunately, most infected individuals do not experience symptoms. Because most carriers don’t know they are infected, it is estimated that nearly 70% of sexually active adults are carriers.
For most individuals, there are no serious complications from this infection, but it can cause infertility in some women. Ureaplasma is treatable with prescribed medication.
Chancroid is often misdiagnosed as syphilis. This STI causes large and painful sores in the genital area. It is more common in Asia and Africa and mostly affects men. But women are not immune to chancroid and can be infected during sexual intercourse or by coming into contact with fluid from an open sore.
Oral medication is an effective treatment along with injections. Those with compromised immune systems may experience difficulty in treating chancroid.
14. Granuloma inguinale
Granuloma inguinale is a prevalent STI in tropical and developing areas and not as common in the United States. If infected, a woman will often experience painless and slowly progressive ulcerative lesions in the genital or perineum areas.
These lesions are large and very red in color. Bleeding is common. Infections can develop and spread to organs or bones. Diagnosis can be difficult, as well as treatment. Very few trials have been conducted regarding the treatment of granuloma inguinale. Prolonged treatment is usually necessary and relapse can occur up to a year and a half after completed treatment.
Medium Risk Causes for STIs
May require an ED visit or hospitalization, prescription medication usually needed
Chlamydia affects nearly 4 million women each year. Signs of Chlamydia in women don’t always present themselves but if they do, vaginal discharge and abdominal pain are the most common. A woman might also misdiagnose themselves with a urinary tract infection should the infection enter the urethra.
If left untreated, Chlamydia in women can damage the Fallopian tubes and lead to pelvic inflammatory disease. Antibiotics can be used to treat Chlamydia symptoms in women and the infection is very responsive. A second Chlamydia treatment is rarely needed.
Gonorrhea is one of the oldest sexually transmitted infections and still prevalent today with nearly one million women estimated to being currently infected. Gonorrhea can be spread through all forms of sexual contact, including oral sex.
Most women do not experience symptoms, but if they do, frequent and burning urination, yellowish vaginal discharge, vaginal itching, and vaginal swelling are the most common signs. The development of a nodule of gonorrhea inside the vagina is also a symptom.
Gonorrhea in women can lead to serious damage of the reproductive system if left untreated. Gonorrhea treatment usually starts with antibiotics but there are antibiotic resistant strains that are becoming more common, in fact, the CDC has concerns that it is becoming a super-bug, with resistance to even powerful antibiotics. If diagnosed with gonorrhea, make sure to finish your treatment in its entirety and schedule an appointment to be re-checked as additional treatment could be necessary.
17. Hepatitis A virus (HAV)
The Hepatitis A virus causes Hepatitis A, a liver disease that is unlikely to develop into a long-term condition. That doesn’t mean it can be ignored though. The virus spreads when an individual ingests infested fecal matter through infected food or beverages or during oral-anal sexual contact with someone infected with the virus.
Symptoms are mild and include fever, fatigue, nausea, vomiting, loss of appetite, dark urine, clay-colored bowel movements, and jaundice. If considered otherwise healthy, medical intervention is not always necessary with symptoms disappearing after several weeks. There is no specified treatment for hepatitis A, but there is a vaccine available.
Hospitalization needed, usually not life threatening but could be
Syphilis is caused by a bacterial organism called Treponema pallidum. There are three stages of syphilis. The first is the formation of a painless ulcer or chancre. When an ulcer is present, the infection is highly contagious. Most women will not progress past this stage and the infection will disappear without treatment.
The second stage involves a skin rash on the bottom of the hands and feet along with hair loss, sore throat, headaches, and white patches in the mouth, nose, and vagina. Wart-like growths can also develop on the genitals.
The disease can then enter a latent stage, where the body carries the infection without symptoms. This can last as long as 20 years. The final stage is the most serious one, and it can cause heart problems, strokes, meningitis, blindness, or deafness. Treatment varies based on the stage of the disease but penicillin injections are a common treatment.
19. Hepatitis B Virus (HBV)
Hepatitis B is caused by a virus that inflames the liver. It is most commonly spread through sexual contact but can also spread through intravenous drug use and blood transfusions, though this is rare due to increased screening protocols.
The development of chronic liver disease is possible. Symptoms only appear in about half of all infected and include a jaundice appearance, fever, abdominal pain, and nausea. In developed cases, swelling of the legs is common along with developing fluid accumulation in the stomach. If either of these occur, Hepatitis B treatment needs to start immediately.
There is a vaccine available at birth to prevent Hepatitis B. If not vaccinated as a baby, an individual can still be vaccinated as an adult.
20. Pelvic inflammatory disease (PID)
PID, or pelvic inflammatory disease, is a serious complication of other STIs, like chlamydia or gonorrhea. The bacteria present from these STIs move upward from the vagina or cervix and enter the reproductive organs, leading to infertility and permanent organ damage.
Symptoms aren’t always obvious but include lower abdominal pain, increased vaginal discharge, irregular menstrual bleeding, fever, pain during intercourse, and abdominal tenderness. PID can cause ectopic pregnancies and chronic pelvic pain.
The disease can be treated with antibiotics but any damage caused by the infection will most likely be permanent.
High Risk Causes for STIs
Life threatening and death is possible, Intensive Care Unit (ICU) care often needed
21. Human Immunodeficiency Virus (HIV)
HIV, or human immunodeficiency virus, makes it more difficult for the body to fight back against any type of bacterial, viral, or fungal invasion. The immune system weakens and becomes unable to fight off infections, even those as common as a cold.
HIV is a viral infection. It is mostly transmitted through sexual contact but can also be spread through intravenous drug use or from mother to child during pregnancy. Can you get HIV from oral sex? Yes, HIV can spread through vaginal, anal, and oral sex, but the risk is lower with oral sex.
If infected, most individuals can be accurately diagnosed with an HIV test kit within 12 weeks of possible exposure. If you believe you were exposed to HIV and test HIV negative within this time frame, speak to your doctor about your next steps.
There is no set list of signs of HIV and according to the CDC, HIV is not always known by the infected. It is estimated that one person out of every seven infected people are unaware of their HIV status 4. But some do experience an overall ill feeling for several weeks. HIV symptoms in women include a fever, muscle pain, headaches, vomiting, and diarrhea. An HIV skin rash is another possible symptom.
While there is no cure for HIV, there are medications that can slow down the progress of the virus. In addition, it is now recommended that all sexually active adults be screened for HIV with a blood test, as part of your annual physical. This is important that both you and your partner know your HIV status before having sexual activity.
22. AIDS (Acquired Immune Deficiency Syndrome)
If you are HIV-positive, you may eventually develop AIDS, or Acquired Immune Deficiency Syndrome. This is when the immune system has been destroyed by the HIV virus and what are known as “opportunistic infections” invade the body—these are infections causes by bacteria, parasites and viruses that are normally easy for health people to eradicate.
AIDS symptoms leave the body’s defense system in such a weak state that it’s difficult to fight off even the smallest infection. The end result of having such a weakened immune system is death.
Modern medicine has made AIDS and the opportunistic infections associated with it extremely unusual, though 15-20 years ago this was not the case. While there is still no cure for AIDS, medication can make the disease manageable, as long as treatment occurs early and correctly. Regardless, safe sexual practices and prevention remain the best defense against this disease.
23. Hepatitis C Virus (HCV)
Hepatitis C is caused by HCV, a virus. The liver becomes inflamed and unable to operate as needed. Though the virus can be transmitted through sexual contact, this is rare. It is typically spread by shared needle usage or pregnancy. Is there a vaccine for Hepatitis C? Not at this time.
Symptoms of HCV are often delayed and sometimes never develop at all5. Hepatitis treatment is necessary though to avoid serious liver complications, like liver cancer or cirrhosis. In extreme cases, a liver transplant is necessary.
Antiviral medicines can help to fight the infection and prevent serious complications but early detection is important.
Can Hepatitis C Be Cured?
If the virus is not detected during a blood test three months after the completion of treatment, the infection is considered cured. However, one will always test positive for HCV – no viral load will be detected. Often, patients must get what is called a “rider” from their doctors so this is not considered for health insurance purposes.
The most efficient way to prevent contracting an STI is to abstain from all sexual contact. But if you are sexually active, there are steps you can take to protect your health.
- Always use a condom during vaginal, anal, and oral sex— though condoms are not 100% effective, they substantially decrease your chances of contracting an STI when used correctly6.
- Get vaccinated if you meet health and age criteria for HPV, HAV, HBV 7.
- Get tested regularly (new partners should be tested as well) – free STI testing is available
- Wash before and after any sexual act
- Avoid drugs and alcohol as you may be more likely to engage in unsafe sex
If you have been diagnosed with an STI, it is your responsibility to prevent the disease from being passed to your current or future partners.
- Avoid all sexual contact until you have seen your doctor
- Avoid sexual contact until you are disease or infection free
- If you have an incurable STI, you must inform any current and future partners. This is the LAW.
- Inform previous partners if there was a possibility they were exposed
- Follow treatment instructions
- Do not engage in sexual activities until your doctor has approved
- Always use condoms when approved for sexual activity
- Be honest with new partners about your current sexual health
Though being diagnosed with an STI can take a toll on your emotional and mental health, proper treatment and aftercare can get you back to a normal routine quickly.
As a woman, your sexual health is important not only for yourself but for your future children, should you desire to conceive one day.
By being proactive about sexual health, by being tested for possible infections when and if you possibly could have contracted one, and remaining vigilant about practicing safe sex, women can lead the way to a healthier future for themselves, their partners, and the world at large.
- CBS News Atlanta. (2014). CDC: 110 million Americans have STDs at Any Given Time. http://atlanta.cbslocal.com/2014/10/06/ cdc-110-million-americans-have-stds-at-any-given-time/
- Teen’s Health. How long is mono contagious? http://kidshealth.org/en/teens/mono-long.html
- FDA. HPV. https://www.fda.gov/forconsumers/ byaudience/forwomen/ucm118530.htm
- AIDS.gov. U.S. Statistics. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
- CDC. HCV. https://www.cdc.gov/hepatitis/ hcv/cfaq.htm
- Planned Parenthood. How to put a condom on. https://www.plannedparenthood.org/ learn/birth-control/condom/how-to-put-a-condom-on
- ASHA. Vaccines. http://www.ashasexualhealth.org/ stdsstis/vaccines/