Doctor's Notes on Sexually Transmitted Diseases (STDs)
Sexually transmitted diseases (STDs) are diseases (infections) that involve the transmission of an infectious organism between sex partners during any sexual activity. Signs and symptoms depend on what type of infectious organism infects the person (bacteria, viruses, protozoan, fungus or parasite). There are too many specific infectious organisms to list here with their possible signs and symptoms but the common signs and symptoms for each type of STD will be mentioned; the reader is advised to get details by searching the name of the infecting pathogen.
Bacterial – urethral or vaginal discharge, pain with urination, ulcers on genitals (some painful, some not painful), abscesses and/or fistulas in the groin and others like rash, fever, headache and joint pains.
Viral – recurring blister sores on the genitals, warts on the genitals, jaundice and flu-like symptoms, liver failure, and HIV symptoms like fatigue, night sweats, swollen lymph nodes, rashes, weight loss, cough, headaches, diarrhea.
Protozoan – frothy vaginal discharge with a strong odor.
Fungi - (please note, not always a STD as many are acquired without sexual contact), reddish itchy groin skin, cheese-like vaginal discharge and burning and itching of the penis or vagina.
Parasites – (please note, not always caused by sexual contact), visible tiny bugs in the pubic hair, intense itching especially at night.
Causes of STDs are the transmission of infectious pathogens by any type of sexual contact to an uninfected sexual partner.
Sexually Transmitted Diseases (STDs) Symptoms
Common STDs have a variety of symptoms (if symptoms develop at all) and many different complications, including death.
Symptoms of STDs caused by bacteria
- Are not common in the United States but common in developing countries.
- Symptoms include painful ulcers on the genitals.
- Can be confused with syphilis or herpes
- Is treatable with antibiotics
- Most common of all STDs caused by bacteria.
- Cause no symptoms in about 80% of women and 50% of men
- When symptoms are present, commonly there is discharge from the vagina or the penis, and burning or pain during urination.
- Is transmitted through vaginal, oral, or anal sexual contact
- Ectopic pregnancy and infertility for women are potential serious complications.
- Is treatable with antibiotics
- Discharge from the vagina or the penis
- Over 50% of infected women have no symptoms, but they can still transmit the disease to others.
- Painful urination
- Ectopic pregnancy, pelvic inflammatory disease (PID), infertility for women, Fitzhugh-Curtis syndrome (perihepatitis) and death are potential serious complications.
- Is treatable with antibiotics, but many strains are becoming resistant to most antibiotics.
Granuloma inguinale (donovanosis) symptoms
- Not common in the U.S.
- Symptoms are painless genital ulcers in the groin area.
- Is treatable with antibiotics, usually for three or more weeks
- Not common in the U.S.
- Symptoms are abscesses (buboes) in the groin, rectum or other areas; fistulas that drain pus may occur and are treatable with antibiotics.
- This disease is treated with antibiotics.
- Symptoms are mild and often go undetected initially
- Starts with a painless genital ulcer that goes away on its own
- Rash, fever, headache, achy joints
- Is treatable with antibiotics
- More serious complications associated with later stages of the disease if undetected and untreated
Symptoms of STDs caused by viruses
- Recurring outbreaks of blister-like sores on the genitals
- Can be transmitted from a mother to her baby during birth
- Reduction in frequency and severity of blister outbreaks with treatment but not complete elimination of infection.
- Can be transmitted by a partner who has herpes even if no blisters are present.
- Caused by a virus related to skin warts, human papillomavirus (HPV)
- Small, painless bumps in the genital or anal areas (sometimes in large clusters that look like cauliflower)
- Various treatments available (for example, freezing or painting the warts with medication)
- Vaccines are available against the most common types of HPV
- Hepatitis B and D are most often associated with sexual contact, hepatitis A, C, E are less frequently transmitted by sexual contact.
- Both may be transmitted via contact with blood; for hepatitis B, sexual transmission is believed to be responsible for 30% of the cases worldwide.
- The hepatitis B virus can cause both an initial (acute) and a chronic form of liver inflammation. Only 50% of acute infections with the hepatitis B virus produce symptoms. The initial phase of infection lasts a few weeks, and in most people (90% to 95%), the infection clears.
- Acute infection can cause yellowish skin and eyes, fever, achy, tired (flu-like symptoms).
- Severe complications in some people, including cirrhosis and liver cancer may occur in a small percent of individuals infected with HBV.
- Treatments are available and remission is possible with some aggressive medications.
- Immunizations are available to prevent hepatitis B.
- Spread primarily by sexual contact and from sharing IV needles
- Can be transmitted at the time a person becomes infected with other STDs
- No specific symptoms or physical signs confirm HIV infection.
- The average time from infection to the development of symptoms related to immunosuppression (decreased functioning of the immune system) is 10 years.
- The following symptoms may occur a few weeks after contracting the virus initially (acute retroviral syndrome, acute HIV infection):
- Serious complications of AIDS include unusual infections or cancers, weight loss, intellectual deterioration (dementia), and death.
- No current cure but medications are available to slow disease progression and make it a chronic, manageable disease.
- Small (2 to 5mm) raised areas (papules) on the skin
- Contagious, usually by direct skin to skin contact
- Self-limited over months to years; treated with some topical creams
- Often cryotherapy (freezing) or surgical removal is performed
Symptoms of STDs caused by protozoan
- Frothy vaginal discharge with a strong odor
- Treated with antibacterial/antiprotozoal medicines
Symptoms of STDs* caused by fungi*
Jock itch (genital itching or Tenia cruris)* (not always an STD)
- Itchy groin skin, sometimes has a reddish color
- Is treated with topical antifungal medicines
Yeast infection (Candidiasis)* (not always an STD)
- Cheese-like vaginal discharge or whitish exudates sometimes with a reddish hue to the skin; it may occur around the foreskin of infected males; common symptoms are itching and burning sensation of the vagina or penis.
- Is treated either with topical or oral antifungal medicines.
Symptoms of STDs caused by parasites
- Very tiny bugs that are found in pubic hair, sometimes referred to as "crabs"
- Can be picked up from clothing or bedding
- First noticed as itching in the pubic area
- Are treatable with creams, anti-lice agents, and combing
- Skin infestation caused by a tiny mite
- Highly contagious
- Intense itching is the primary symptom, which worsens at night
- Spread primarily by sexual contact or from contact with skin, infested sheets, towels, or furniture
- Is treated with creams
Sexually Transmitted Diseases (STDs) Causes
Depending on the disease, STDs can be spread with any type of sexual activity. STDs are most often caused by viruses and bacteria. The following is a list of the most common STDs, their causes. Additionally, there are other infections (see STDs with asterisk mark*) that may be transmitted on occasion by sexual activity, but these are typically not considered to be STDs by many investigators:
STDs caused by bacteria
- Chancroid (Haemophilus ducreyi)
- Chlamydia (Chlamydia trachomatis)
- Gonorrhea (Neisseria gonorrhea)
- Granuloma inguinale (Calymmatobacterium granulomatis)
- Lymphogranuloma venereum (Chlamydia trachomatis)
- Syphilis (Treponema pallidum)
STDs caused by viruses
- Genital herpes (herpes simplex virus)
- Genital warts (human papillomavirus virus [HPV])
- Hepatitis B and D, and infrequently, A*,C*,E* (hepatitis viruses, types A-E)
- HIV/AIDS (human immunodeficiency virus [HIV virus])
- Molluscum contagiosum* (poxvirus)
STD caused by protozoan
- Trichomoniasis (Trichomonas vaginalis)
STD's* caused by fungi
- Jock itch (Tenia cruris)*
- Yeast infections* (Candida albicans)
STD's caused by parasites
For details about the pathogens that cause the diseases, the reader is urged to search the specific disease by simply clicking on it.
It's not necessary to have sexual intercourse to get a sexually-transmitted disease (STD). The human papillomavirus (HPV) that causes genital warts can be transmitted by close skin-to-skin contact. Some types of HPVs cause cervical or anal cancer, and vaccines are available to protect against the most dangerous types. Other HPV types cause genital warts, which can be raised, flat, or cauliflower-shaped. HPV infection can occur in people who have no symptoms or visible warts.
- Genital warts can be big or small, flat or raised. They generally appear as a small bump or group of bumps in the genital region, and may be shaped like a cauliflower.
- A vaccine to prevent HPV is given in three shots. The second shot is given a month or two after the first shot. The third shot comes six months after the first shot.
- The Centers for Disease Control recommends boys and girls be vaccinated at ages 11 or 12.
- If they did not get the HPV vaccine as children, women can get the HPV vaccine through age 26. Men can get it through age 21. The CDC recommends HPV vaccination for men through age 26 for men who have sex with men or men with compromised immune systems, including HIV.
STD : Symptoms, Testing & List QuizQuestion
Condoms are the best protection from sexually transmitted diseases (STDs).See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.