STD symptoms: What are the early signs of an STD in females?

Sexually transmitted diseases (STDS) are caused by sexually transmitted infections (STIs) and are quite common among women, particularly ages 15 to 24 years. Although STIs are mainly spread by sexual contact, they can also be spread through nonsexual contact, such as to infants during pregnancy or childbirth or through blood transfusions or shared needles, according to Mayo Clinic. STIs affect about 1 in 5 people in the United States. There are over 20 different STIs that women can contract, and the symptoms they experience depend partly on the type of STI they have, according to the National Institutes of Health (NIH).

Some symptoms of STIs in females are very mild, and some STIs don’t have symptoms at all. Other times, especially as the weeks and months go on, STIs can cause noticeable symptoms, such as unusual vaginal discharge, pain during sex or when urinating, itching, redness, and sores or warts in the genital area. Sometimes, severe pelvic pain, rashes, and fever accompany these symptoms.

Some of the STI symptoms in women resemble other conditions, such as urinary tract infections, yeast infections, or bacterial vaginosis. That’s why it’s important to visit a healthcare provider for a proper diagnosis and treatment plan.

 Key takeaways:

• Early signs of STIs include vaginal discharge and pelvic or vaginal pressure.
• Serious symptoms of STIs, such as rash, fever, vomiting, abdominal pain, or severe pain, may require immediate medical attention.
• STIs are caused by viruses, bacteria, and parasites. You may be at risk for developing STI symptoms if you have unprotected sex.
• STIs usually require a medical diagnosis and resolve with treatment within a week or so.
• Treatment of STIs may include antibiotics and antivirals. Read more about treatment for STIs such as chlamydia and gonorrhea.
• Untreated STIs could result in complications like pelvic inflammatory disease, chronic pelvic pain, sepsis, tubo-ovarian abscesses, ectopic pregnancy, and infertility.
• Use coupons for STI treatments like azithromycin and metronidazole to save up to 80%.

What are the early signs of an STI in females?

The early signs of STIs in women are usually vaginal or urinary, says Michael Savino, MD, director of quality for the department of urology at Northwell Staten Island University Hospital in New York.

“Vaginal symptoms include malodorous vaginal discharge that can be of yellow or green color, which may suggest gonorrhea,” Dr. Savino says. It may be associated with feelings of pressure in your vagina.

Early signs of infections like human papillomavirus (HPV) or herpes simplex virus (HSV) may include a cervical or vaginal growth, such as a wart of a clear papule, according to Dr. Savino. Early HIV symptoms may include flu-like symptoms and mouth ulcers.

The timeline of STI symptoms depends on the infection that you have. Most STIs start with few symptoms or no symptoms at all. Some take weeks or months to present themselves. Other STIs take years to show symptoms or never show symptoms at all, even though you may be a carrier of the infection and can pass it on to others.

According to the Centers for Disease Control and Prevention (CDC), different STIs have varying incubation periods, which is the time between when you become infected and when you show symptoms:

• Chlamydia: Seven to 21 days
• Gonorrhea: One to 14 days
• Syphilis: 10 to 90 days
• HSV: Two to seven days
• HPV: Four to 240 days
• Trichomoniasis: Five to 28 days

Other STI symptoms in females 

Sometimes, STI symptoms in women are more subtle. “Some less obvious signs of STIs may include mild symptoms or those that mimic other conditions, making diagnosis challenging, including fatigue, flu-like symptoms, or general discomfort,” says Michael Green, MD, OB-GYN and co-founder at Winona.

According to Mitchell Kramer, MD, chairman of the Department of Obstetrics and

Gynecology at Huntington Hospital in Huntington, New York, more subtle STI signs can be a slight discomfort in the vaginal or vulvar area, pelvic pressure or discomfort, changes in bladder or bowel habits, and anal itching.

Sexually transmitted disease vs. STI symptoms 

According to the CDC, STIs describe the state of being infected with a sexually transmitted pathogen, whereas STIs describe the disease that develops as a result of the infection. However, the two terms are often used interchangeably.

According to Cleveland Clinic, STI and STI are umbrella terms used to describe viruses, bacteria, and parasites that can be transmitted through sexual relations.

Types and stages of an STI: How can I tell which one I have?

“STIs often progress through different stages, but not all infections follow the same pattern,” says Dr. Green. “Stages may include initial infection, latency, and reactivation.”

One well-known STI that presents in stages is genital herpes. In its primary stage, genital herpes has severe symptoms that include painful lesions, swollen lymph nodes, fatigue, and fever. But in the reactivation stage, the disease has milder symptoms (genital ulcers) that last for a shorter period of time.

Syphilis is the most well-known STI to go through a series of distinct stages, according to the CDC:

• In the primary stage, syphilis is characterized by sores of your vagina, anus, rectum, or mouth.
• In the secondary stages, you may notice rashes on your body, including your genital, anal, or mouth area, but also on your palms, hands, and bottom of your feet. You may also have a fever, sore throat, hair loss, swollen glands, and fatigue.
• In the latent stage, you will have no symptoms, but the STI will remain in your body, especially if you aren’t treated.
• In the tertiary stage, syphilis is very serious and can damage internal organs. Tertiary syphilis is very serious and occurs 10–30 years after being infected. 

When to see a doctor for STI symptoms

If you have any STI symptoms, you should make an appointment with a healthcare provider right away. “Usually, you’ll want to see your OB-GYN, but you can also go to your primary care provider or to urgent care,” Dr. Kramer says. Most of the time, you don’t need to visit an emergency room for STI symptoms, but if you have a fever, vomiting, dizziness, or extreme fatigue, you should seek emergency care.

In addition to getting tested when symptoms are obvious, you should also get tested and screened for STIs if you have had experiences that put you at increased risk. “Risk factors such as unprotected sexual activity with multiple sexual partners associated with any of the aforementioned symptoms should raise the risk and suspicion of STI and therefore prompt immediate evaluation,” Dr. Savino says.

STIs are diagnosed in the following ways, according to Mayo Clinic:

• Examination, either external or internal (for herpes ulcers, syphilis or chancroid ulcers, warts, and molluscum)
• Blood tests for STIs like HIV, Hepatitis B or C, or syphilis
• Urine tests (for gonorrhea, chlamydia, and trichomonas)
• Testing of fluid samples from infection sites, such as sores or blisters
• Vaginal or cervical samples (for human papillomavirus, gonorrhea, chlamydia, trichomonas, candida,  or bacterial vaginosis)

Complications of STIs in women

It’s important to treat STIs in females, not only to relieve uncomfortable symptoms but also to prevent possible complications that can arise.

According to the National Institute of Allergies and Infectious Diseases, possible complications of untreated STIs depend on which STI you are infected with but may include:

• Pelvic inflammatory disease 
• Chronic pelvic pain
• Abscesses
• Abdominal infections
• Sepsis
• Ectopic pregnancy
• Pregnancy loss
• Cervical cancer
• Infertility
• Neonatal infections (passed from mothers to their babies during pregnancy and childbirth)

How to treat female STI symptoms

STIs in females need to be treated to reduce symptoms, decrease the risk of transmission, and reduce the risk of serious complications. STIs don’t just resolve on their own.

The type of treatment required varies based on the pathogen you are infected with. According to the NIH:

• STIs caused by bacteria need to be treated with oral or injectable antibiotics.
• Parasite or yeast are treated with oral or topical medications.
• Viral STIs are treated with antivirals, which don’t completely eliminate the virus but can reduce symptoms and the risk of transmitting the virus to others.
• Topical destruction treatment (acid application or cryotherapy) for warts or molluscum contagiosum.
• People infected with HIV need to take antiretroviral drugs.

Living with an STI

For most people, getting treatment for STIs means that they can live full and healthy lives. Some STIs can be cured by treatment, including those caused by bacteria or parasites. STIs caused by viruses, such as HIV, genital herpes, hepatitis, and HPV, can’t be cured, according to the NIH. Still, treatments for these infections can decrease symptoms significantly and also decrease your risk of infecting others.

Most importantly, see a provider right away if you know you’ve been exposed to HIV or if you have symptoms such as vaginal or pelvic pain, unusual discharge, genital sores, or a new rash.

Although STI symptoms in women can resemble other conditions, like UTIs and yeast infections, STI symptoms require a proper diagnosis and treatment. Only your healthcare provider can rule out infection or other serious health conditions. Visit your doctor to determine the best way to manage the symptoms of an STI.