The rates of several sexually transmitted diseases (STDs) in the United States have dramatically increased in recent years.
Gonorrhea cases were up 45 percent and syphilis cases were up 52 percent since 2016, according to the Centers for Disease Control and Prevention (CDC).
Cases of chlamydia — the most frequently reported bacterial STD — were slightly down since 2016 but this is believed to be due to decreased STD screening during the COVID-19 pandemic.
Concern over STDs remains high, especially for chlamydia, gonorrhea and syphilis, the most common bacterial STIs. Untreated, these STDs can have serious health consequences, including:
- Increased risk of giving or getting HIV, the virus that causes AIDS
- Long-term pelvic/abdominal pain
- Inability to get pregnant or pregnancy complications
An STD, also known as a sexually transmitted infection or STI, is passed from an infected person, usually unknowingly, to an uninfected person during sex, but it can also spread whenever there is bodily fluid exchange.
Chlamydia, gonorrhea and syphilis are bacterial infections that can be spread simply by touching an infected area. It isn’t necessary for a man to ejaculate in order to pass the infection to his partner. Many people infected with these diseases may not know it, which increases the risk of spreading.
“These infections often have minimal or no symptoms in their early stages,” says Varinthrej Pitis, MD, a primary care physician at Scripps Clinic Carmel Valley. “Without treatment, persistent or inappropriately treated infections can lead to serious complications from pelvic inflammatory disease, infertility, neurological consequences, joint problems and congenital birth defects.”
STDs are also caused by viruses, including HIV, human papillomavirus (HPV), hepatitis B and herpes.
While monkeypox is not considered an STD because it can spread in other ways, the viral disease has added another layer of public health concern as it has been spreading largely between men who have sex with men.
While anyone who is sexually active can get an STD, the people most affected include young people between the ages of 15 to 24, gay, bisexual and other men who have sex with men, pregnant people and people from racial and ethnic minority groups. The CDC provides STD screening recommendations for these groups.
The following are commonly asked questions about chlamydia, gonorrhea and syphilis
Chlamydia is most common in young people. One in 20 sexually active young women, ages 14 to 24, has chlamydia, according to the CDC. Chlamydia can be passed from a woman to her baby during childbirth.
Chlamydia is often a silent infection. Most people with chlamydia have no symptoms or abnormal physical exam findings. Screening is necessary to identify most infections.
Women who have symptoms may notice the following:
- Unusual vaginal discharge, itching or burning
- Bleeding between periods
- Painful periods
- Abdominal pain with fever
- Pain during urination or sex
Chlamydia symptoms in men may include:
- Clear or cloudy discharge from the penis
- Burning and itching at the tip of the penis
- Pain and swelling around the testicles
- Pain during urination
Other symptoms may include:
- Rectal itching, mucus-like rectal discharge and spots of bright red blood on toilet tissue
- Painful rectum during bowel movements
- Sore throat and swollen lymph nodes in the neck
Most cases of chlamydia are treated successfully with oral antibiotics.
“With all of these diseases, your partners need to also be treated to prevent reinfection and spreading the diseases further,” says Dr. Pitis. “If you are exposed to the bacteria again after being treated, you can still develop a recurrent infection.”
Untreated chlamydia can cause pelvic inflammatory disease in women, which can lead to infertility. Antibiotics cannot treat damages that have already been done by the infection, such as scar tissue from an infection that can lead to infertility.
In pregnant women, it may increase the risk of premature birth, premature rupture of membrane, or ectopic pregnancy, which means the fertilized egg develops outside of the uterus. Infected babies may develop an eye infection or pneumonia.
In men, untreated chlamydia can lead to infection of the urethra or epididymis (the tube that carries sperm from the testes).
Gonorrhea is the second most commonly reported bacterial STD, Pregnant women can also pass gonorrhea to their newborn babies.
Gonorrhea often has no symptoms but can still cause serious health problems.
Symptoms in women may include:
- Increased vaginal discharge
- Painful urination or intercourse
- Vaginal bleeding between periods
- Abdominal or pelvic pain
Symptoms in men may include:
- Painful urination
- Discharge from the penis
- Pain or swelling in a testicle
Symptoms also may include:
- Rectal itching, pus-like discharge and spots of bright red blood on toilet tissue
- Eye pain, pus-like discharge from one or both eyes and sensitivity to light
- Sore throat and swollen lymph nodes in the neck
- Warm, red, swollen and extremely painful joints
Gonorrhea is treated with different antibiotics due to its rising resistance over the years.
Without appropriate treatment, gonorrhea complications are similar to chlamydia. In women, it may cause pelvic inflammatory disease, infertility and increase the risk of HIV infection. In men, it can result in epididymitis, which causes pain and swelling in the testicles.
In addition, bacteria can spread through the bloodstream, infecting the joints, heart valves, bone and brain, and causing fever, skin sores and rash.
Babies who contract gonorrhea during childbirth may have serious vision problems and infections.
Syphilis cases continue to increase. Case rates are increasing among gay, bisexual and other men who have sex with men, according to the CDC.
Syphilis can be spread through sexual activity, kissing, or bodily contact with skin sores that develop in the early stages of the disease.
Syphilis has three stages. The disease also may be latent, which means it is inactive and has no symptoms.
Primary (early) syphilis causes small, painless sores on the genitals or mouth between 10 to 90 days after exposure. Because the sores are painless, most people who are infected are not aware. The sores heal within six weeks even without treatment, but the person is still infected and contagious.
Secondary syphilis starts six weeks to six months after exposure and causes a copper-colored rash on the palms of the hands and soles of the feet, along with body rashes. Other symptoms may include moist warts in the groin, white patches inside the mouth, swollen lymph glands and fever. Secondary syphilis symptoms also go away without treatment.
Tertiary syphilis is rare and can appear many years after an infection. It can affect the heart, brain and nerves and cause dementia, paralysis, blindness, hearing loss and impotence. Without treatment, syphilis can be fatal.
Treatment for syphilis usually involves one or more doses of antibiotics.
If syphilis is not treated, it can cause serious problems, including brain and nerve problems, eye problems and even blindness.
Babies who contract congenital syphilis (passed from mother to baby during pregnancy) may be stillborn or die shortly after birth. Others may have developmental delays, seizures, deafness or other significant health problems.
The number of congenital syphilis cases has risen to 2,148 cases, up 235 percent from 2016, according to the CDC.
Follow these precautions to help reduce your risk of STDs:
- Use condoms correctly every time you have sex.
- Limit sexual contact to one uninfected partner.
- Get tested for STDs when you have a new partner or if you have symptoms.
- Avoid sex with someone who has symptoms or has several partners.