This article will cover the various Symptoms of Sexually Transmitted Diseases (STDs) which can occur in women.
STDs in women can be acquired through various exposures:
- Penetrative intercourse (penile insertion into the vagina)
- Oral intercourse (cunnilingus – allowing their partner to use his/her mouth on the vagina)
- Insertion of fingers or sex toys into the vagina
No Symptoms Does Not Equate No STD!
However, before we begin, it is crucial to remember that not all STDs necessarily cause symptoms!
Infections like chlamydia may not cause any symptoms but can spread upwards and affect the Fallopian tubes, causing inflammation and scarring and leading eventually to infertility. Infection with high-risk strains of the Human Papilloma Virus (HPV) cause no symptoms initially and by the time symptoms develop, it means there are abnormal cell changes and possibly even full-blown cervical cancer.
If you are sexually active, it is important to do your regular PAP smears and STD testing, especially if you have a new partner or any reason to be concerned about an infection, even if you feel completely fine. Getting the HPV vaccine is also part of protecting yourself and your health. See: Cervical Cancer, Pap Smear & HPV Vaccination – What You Need To Know
STD Symptoms in Women
STDs in women can give rise to symptoms that can be broadly categorised as follows:
1. Vaginal Discharge – An abnormal vaginal discharge which may be different in colour, quantity or consistency, or malodorous, spotting in between periods (intermenstrual bleeding)
2. Skin Symptoms – abnormal genital blisters, ulcers, bumps
4. Urinary Symptoms – dysuria (discomfort/pain on passing urine), urgency and frequency (feeling the urge to pee often)
5. General/nonspecific Symptoms – fever, swollen lymph nodes, rashes over the rest of the body, abdominal pain
1. Vaginal Discharge
Abnormal vaginal discharge is the most common symptom women may get from an STD. Abnormal vaginal discharge may be different in colour (e.g. yellowish, greenish, brownish even), consistency and volume. It may be associated with a foul smell or itching and discomfort or spotting in between menses.
- Chlamydia (STD) – a yellowish, watery discharge
- Gonorrhoea (STD) – thick, pus-like yellow discharge
- Trichomonas (STD) – frothy, greenish discharge associated with itching
- Bacterial vaginosis (not an STD) – thin, greyish watery discharge with a fishy odour
- Yeast (not an STD) – whitish, clumpy, curd-like discharge associated with itching and possibly soreness
While there are so-called “classic textbook” descriptions of the discharge caused by various STDs, realistically speaking, it is difficult to make a diagnosis purely based on appearance. Not everyone has the classic abnormal discharge described. Furthermore, multiple infections can coexist. A vaginal swab test is often warranted.
STDs that cause Abnormal Vaginal Discharge:
- Mycoplasma spp,
Symptoms usually surface within a few days to weeks from exposure (usually up to a month).
- Why Do I Have Abnormal Vaginal Discharge
- An Overview on Gonorrhoea
- An Overview of STDs from A STD Doctor
2. Skin Symptoms
Genital blisters, ulcers and bumps can be signs of STDs. These may occur anywhere on the genitals, including the labia majora, labia minora, around the anal region and even inside the vaginal canal where they may be less visible.
STDs that cause Blisters, Ulcers and Bumps:
Blisters – Early stages of Genital Herpes (Herpes Simplex Virus; HSV)
- Painful, multiple – later stages of Genital Herpes (HSV)
- Painless, single – syphilitic chancre (primary syphilis)
- Painless, multiple – snail track ulcers (secondary syphilis)
- Painful, single, large ulcer associated with swollen, tender groin lymph nodes – chancroid (Hemophilus ducreyi)
- Single or multiple, skin coloured, sometimes but not necessarily cauliflower-like growths -warts (Human Papilloma Virus; HPV)
- Usually multiple small pearly bumps sometimes with a central umbilication (like a dimple) – Molluscum contagiosum
These symptoms can appear weeks to months after exposure. For instance, HSV may cause painful blisters and ulcers a week or two after you contract it. Syphilitic ulcers may occur within 9 to 90 days. Warts caused by HPV can take several months to develop.
- Genital Warts – The Cauliflower Like Lumps
- Causes of & Treatment for Genital Blisters, Genital Warts and Genital Ulcers
- Painless STD Sore & Rashes: SYPHILIS
- HIV Rash? – Other STD-Related Rashes
- 10 Causes of Abnormal Vaginal Lumps & Bumps
3. Sexual Symptoms
Pain during intercourse (known as “dyspareunia”) or bleeding after intercourse (“post-coital bleeding”) can be signs of an STD.
The presence of infection causes the cervix tissue to be unhealthy and inflamed. This leads to the cervix being more sensitive during intercourse, resulting in pain. Pain during intercourse may also be a sign of a deeper and more serious infection known as a pelvic inflammatory disease, which can result from untreated Chlamydia or Gonorrhea.
Unhealthy, inflamed tissue also bleeds more easily and this explains bleeding after intercourse. Also, if there are abnormal cells at the cervix (or even cervical cancer caused by HPV), bleeding may occur more easily from this unhealthy tissue.
During a PAP smear or endocervical swab test, your cervix may also appear abnormal or may bleed way more easily.
STDs responsible for Dyspareunia and Post-coital bleeding:
- Mycoplasma spp,
- Ureaplasma spp,
- 11 Causes of Dyspareunia (Pain During Intercourse)
- What are the Causes and Treatment for Post-coital Bleeding)
4. Urinary Symptoms
STDs may sometimes cause symptoms similar to common Urinary Tract Infections – dysuria (pain or a burning sensation on passing urine), urgency and frequency (feeling like you need pass urine more frequently).
In some situations, a painful herpetic ulcer or blister on the labia may result in pain during urination – and women may not realise the ulcer is there until their doctor picks it up on physical examination in the clinic.
STDs responsible for urinary symptoms:
- Mycoplasma spp.,
- Ureaplasma spp,
- Herpes Simplex Virus (causing blisters or ulcers on the skin)
Symptoms may surface within days to a month or so from point of exposure.
5. General Symptoms
These symptoms are not specific and do not necessarily point to an STD.
Fever can occur in any type of infection, and while it is classically quoted as a sign of HIV infection, having a fever does NOT mean you have HIV. Common infections occur more commonly and you are just as likely to have a run-of-the-mill viral illness instead.
Swollen lymph nodes
Swollen lymph nodes occur in response to infection – groin lymph nodes can swell up in infections affecting the pelvic or groin region. These include STDs like Chlamydia, Gonorrhea, chancroid (caused by Hemophilus ducreyi) etc. Non-STD infections like an infected groin cyst can also cause swollen lymph nodes. Lymph node swelling has to be taken in context.
Syphilis may give a generalised rash that can appear anywhere on the body, classically including the palms and soles. HIV is another STD which can cause a rash as well.
this can be a sign of a vaginal STD that has spread upwards to affect the cervix, the womb (uterus) and even the fallopian tubes, in a serious condition known as pelvic inflammatory disease.
- What are the Signs & Symptoms of HIV & AIDS
- How Can HIV be Transmitted – An Overview
- HIV Window Period – Timelines for Accurate HIV Test
- Pills that Prevent HIV – HIV PrEP & HIV PEP
- How Do I Get An Anonymous HIV Test in Singapore
- 10 Common Causes of HIV related Opportunistic Infection
If you are experiencing any of the above symptoms, it is best to get checked as soon as possible! But remember: not everyone with an STD develops symptoms, so even if you feel fine, you should still do your STD tests. Early detection and treatment are crucial to avoiding long term complications. You can visit any of our women’s clinic, or call us or email us for an appointment firstname.lastname@example.org
Stay safe, stay healthy.