Written by Christine Richmond

When you hear “sexually transmitted disease” (STD), some not-so-comforting visuals likely come to mind. You’d certainly notice that, right?

Perhaps, but not every STD sticks out. Of the 20 million new sexual transmitted infections that occur in the United States each year, roughly 85 percent of them show no or unnoticeable symptoms, says Peter Leone, M.D., professor of medicine, Division of Infectious Diseases, and adjunct associate professor of epidemiology, Gillings School of Global Public Health at the University of North Carolina. “That doesn’t mean [STDs] don’t have consequences—they do,” he explains. “But unless you’re being screened, they may be missed.”

Dr. Leone notes that many STDs can be cured with a round of antibiotics—and all STDs can be managed with medications that minimize symptoms and help prevent them from spreading to your partner [1]. But if left untreated, STDs might potentially increase your risk of getting and spreading HIV [2,4]. Untreated STDs might also cause chronic abdominal pain and infertility [2,5]. The Centers for Disease Control and Prevention (CDC) estimates that 24,000 women each year become infertile due to an undiagnosed STD. [6]

Getting tested for STDs during the COVID-19 pandemic can be challenging: Roughly 80 percent of sexual health screening clinics in the United States have closed or reduced hours, according to a survey from the National Coalition of STD Directors [3]. But that doesn’t mean you’re out of options. The survey notes that at-home testing kits can be a viable solution to help keep yourself safe if you’re sexually active.

Here, Dr. Leone highlights five of the most common STDs that don’t show obvious symptoms, how to spot any subtle signs of infection, and when to seek help.


Silent STD #1: Chlamydia


Who does it affect?


One of the most common bacterial STDs (about 2.86 million people are infected annually in the United States), roughly two-thirds of those cases occur in people age 24 or younger. [7]


Are there any subtle symptoms?


The vast majority of people with chlamydia—up to 95 percent of women and up to 90 percent of men—have no symptoms at all. If you notice symptoms, they’re typically mild: Vaginal discharge and burning during urination for women, and urethral discharge and burning during urination for men. [7]


What are the long-term affects I should worry about?


If left untreated, chlamydia can cause pelvic inflammatory disease and scarring that can lead to infertility. It can also increase your risk of acquiring and transmitting HIV. Pregnant women with chlamydia are at a greater risk of a preterm delivery, and their infants can develop potentially dangerous conjunctivitis or pneumonia. [7]


Is it treatable or easily cured?


Yes, chlamydia can be cured with a single-dose antibiotic. [7]

Get tested for chlamydia at home.


Silent STD #2: Gonorrhea


Who does it affect?


There are approximately 1.14 million gonorrhea infections in the United States every year, and about half are in people age 24 or younger. [8,9]


Are there any subtle symptoms?


For men, urethral discharge or mild discomfort while urinating can be common. Most women, on the other hand, will experience no symptoms at all, says Dr. Leone. Those who do report symptoms commonly have vaginal discharge or bleeding between periods. Anal and oral gonorrhea infections are also possible and are usually asymptomatic. [8,9]


What are the long-term effects I should worry about?


Over time, gonorrhea can cause pelvic inflammatory disease and damage a woman’s fallopian tubes, which can impact her fertility. It may also put both men and women at a greater risk of contracting and spreading HIV. [8,9]


Is it treatable or easily cured?


Yes, gonorrhea can be cured with antibiotics. But untreated infections in the general population may be contributing to antibiotic resistance, says Dr. Leone. There used to be several antibiotics that could treat gonorrhea, but the bacteria has built up a resistance to the drugs. Today, there’s only one class of antibiotics left that can knock out an infection. [8,9]

Get tested for gonorrhea at home.


Silent STD #3: Genital Herpes


Who does it affect?


Every year, 776,000 Americans get a new genital herpes infection. And about 87 percent of them don’t get diagnosed. This viral STD “typically has mild symptoms, so it’s missed,” says Dr. Leone. You can also shed the virus even if you don’t have sores—which means you can be contagious and not realize it. [10]


Are there any subtle symptoms?


If you do have symptoms, they may be all over the map, according to Dr. Leone. “It could be a small little area that looks like irritation or mild burning or itching,” he says. But often there is nothing to point to at all. [10]


What are the long-term effects I should worry about?


Untreated genital herpes isn’t linked to any chronic health issues, but being infected may make you roughly two to four times more likely to get HIV, especially if you have lesions. And a mother can pass the virus to her child during birth—a big concern for women who get herpes for the first time while pregnant. [10]


Is it treatable or easily cured?


There’s no cure for herpes, but there are drugs (generic ones, so they’re typically affordable) that will reduce the frequency of outbreaks and lessen the chances that you’ll pass the virus on to a partner. [10]
“Condoms work well to reduce the risk,” Dr. Leone says, noting that vaccines are currently under development.

Get tested for herpes at home.


Silent STD #4: Human papillomavirus (HPV)


Who does it affect?


About 79 million Americans have HPV, making it the most common STD. There are more than 100 strains of HPV, 40 of which can infect the mouth, throat, genital, and anal areas. Thirteen of those 40 have been identified as potential cancer risks [11,12,13]. Still, “only about 3 to 5 percent of infections result in cancer,” Dr. Leone explains.


Are there any subtle symptoms?


Some strains of HPV can cause warts on the genitals or around the anus. Oral HPV can sometimes cause a long-lasting sore throat and pain when swallowing. Other HPV strains don’t show any symptoms and clear up on their own. [11,12,13]


What are the long-term effects I should worry about?


Unfortunately, HPV can cause cervical or anal cancer, and it is responsible for about one-third of all head and neck cancers, Dr. Leone says. [11,12,13] That’s why it’s critical to regularly monitor yourself for HPV and get tested.


Is it easily treatable or cured?


While there is no treatment, there is a vaccine that protects against the most dangerous types of HPV. The CDC recommends that everyone under age 26 get the vaccine, with the first dose ideally happening at age 11 or 12. [11,12,13]

Get tested for HPV at home.


Silent STD #5: Trichomoniasis


Who does it affect?


About 3.7 million Americans have this STD, which is caused by a parasite. [14]


Are there any subtle symptoms?


Only about 30 percent of people who contract trichomoniasis show any symptoms, and they’re usually fairly mild (slight discharge, itching). [14]


What are the long-term effects I should worry about?


Left unchecked, trichomoniasis can trigger inflammation that makes you more susceptible to an HIV infection. The parasite can also cause preterm labor. [14]


Is it easily treatable or cured?


Although some forms of medication can cure trichomoniasis, about one in five people who have had trichomoniasis will get it again within three months. That’s why it’s important to talk to recent sexual partners about your diagnosis and make sure they get treatment, too. [14]

Get tested for trichomoniasis at home.


References


  1. U.S. Department of Health and Human Services
    National Institutes of Health
    Eunice Kennedy Shriver National Institute of Child Health and Human Development
    https://www.nichd.nih.gov/health/topics/stds/conditioninfo/specific

  2. Centers for Disease Control and Prevention
    STDs and HIV – CDC Fact Sheet
    https://www.cdc.gov/std/hiv/stdfact-std-hiv-detailed.htm

  3. Sexual Health Clinics and Our Nation’s COVID-19 Response
    https://www.ncsddc.org/wp-content/uploads/2020/10/Clinic-Call-Report-10.23.2020-final.pdf

  4. Centers for Disease Control and Prevention
    About HIV
    https://www.cdc.gov/hiv/basics/whatishiv.html

  5. Centers for Disease Control and Prevention
    STDs & Infertility
    https://www.cdc.gov/std/infertility/default.htm

  6. Centers for Disease Control and Prevention
    Sexually Transmitted Infections Among Young Americans
    https://www.cdc.gov/std/products/youth-sti-infographic.pdf

  7. Centers for Disease Control and Prevention
    Chlamydia – CDC Fact Sheet (Detailed)
    https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm

  8. Centers for Disease Control and Prevention
    Gonorrhea – CDC Fact Sheet (Detailed Version)
    https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm

  9. Centers for Disease Control and Prevention
    Antibiotic-Resistant Gonorrhea Basic Information
    https://www.cdc.gov/std/gonorrhea/arg/basic.htm

  10. Centers for Disease Control and Prevention
    Genital Herpes - CDC Fact Sheet (Detailed)
    https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm

  11. Centers for Disease Control and Prevention
    Genital HPV Infection – Fact Sheet
    https://www.cdc.gov/std/hpv/stdfact-hpv.htm

  12. U.S. Food & Drug Administration
    HPV (human papillomavirus)
    https://www.fda.gov/consumers/women/hpv-human-papillomavirus#:~:text=There are over 100 different,%2C 11%2C 16 or 18.

  13. Centers for Disease Control and Prevention
    Basic Information about HPV and Cancer
    https://www.cdc.gov/cancer/hpv/basic_info/

  14. Centers for Disease Control and Prevention
    Trichomoniasis
    https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm