STD Symptoms

STD Symptoms in Men and Women

Confidential. Discreet . Private – STD Clinic Singapore

Sexually transmitted diseases (STDs) can be transmitted through various sexual activities – oral, anal, or vaginal intercourse. Anyone who is sexually active is at potential risk of an STD.

dr tan and partners

It is a common misconception that not having symptoms means that one does not have any STD. While some STDs may indeed cause symptoms, a good number of STDs can actually be completely asymptomatic. Some STDs may also only cause symptoms much later, when the disease is more severe. People who look and feel entirely well can still have and transmit an STD to their sexual partners.

Furthermore, as you will see later in this article, many STDs may cause similar symptoms. Certain STDs also cause very nonspecific symptoms which may often be wrongly attributed to other medical conditions.

One should never assume that one is clear of STDs; the only certain way to know is to get screened. – STD Symptoms

Note on STD Symptoms

DTAP STD Clinic Singapore

Do see a doctor and get yourself screened if you have any STD symptoms that may suggest an infection.

If you feel well but are sexually active and have never been screened before, or have a new sexual partner, do remember that a lack of STD symptoms DOES NOT equate being free of STDs! – STD Symptoms

STD Symptoms and STD Treatment

Chlamydia

Chlamydia is the most common STD worldwide. It is a bacterial STD caused by Chlamydia trachomatis and can occur in the genital tract or even be carried in the throat. Chlamydia can frequently be completely asymptomatic, particularly in women. Studies estimate up to half of the men and 70-90% of women with Chlamydia may not have any symptoms whatsoever.

Symptoms of Chlamydia can include urethritis (inflammation of the urine tract),  epididymoorchitis (inflammation of the testicles or epididymis), vaginitis, cervicitis and pelvic inflammatory disease (involving the uterus and fallopian tubes)

If symptoms do occur, they usually surface from a few days to 2-3 weeks after the initial infection.

In men:

  • Painful urination
  • Penile discharge
  • Urinary urgency or frequency.
  • Chlamydia can also cause more serious infections like epididymoorchitis, where one experiences pain and swelling of the testicles or epididymis (a gland that sits near the testicle).
  • Anal pain and discomfort can occur with Chlamydia infections of the rectum, transmitted through anal intercourse

In women:

  • Abnormal vaginal discharge
  • Bleeding after intercourse
  • Abnormal spotting in between menstrual periods
  • Pain during sexual intercourse
  • Chlamydia can cause a more serious infection known as a pelvic inflammatory disease where the infection spreads to affect the uterus and fallopian tubes. This may manifest as abdominal pain and fever but can frequently be mild and silent
  • Infertility due to scarring of the fallopian tubes is a possible late symptom of undetected Chlamydia

Rapid STD Test for Chlamydia and Gonorrhoea PCRis available in all our clinics in Singapore – Next Day STD Results

(Detect the DNA of both Chlamydia and Gonorrhoea in real-time)

Gonorrhea

Gonorrhoea is a bacteria STD of the genital tract and can also occur in the throat from oral intercourse. Gonorrhoea Symptoms tend to surface within a few days up to 2 weeks after the initial infection.

STD Symptoms in Men

  • Painful urination
  • Thick, pus-like penile discharge
  • Urinary urgency or frequency
  • Gonorrhea can also cause more serious infections like epididymoorchitis, where one experiences pain and swelling of the testicles or epididymis (a gland that sits near the testicle).
  • Anal pain and discomfort can occur with Gonorrhea infections of the rectum, transmitted through anal intercourse

STD Symptoms In women:

  • Abnormal vaginal discharge
  • Bleeding after intercourse
  • Abnormal spotting in between menstrual periods
  • Pain during sexual intercourse
  • Gonorrhea can cause a more serious infection known as pelvic inflammatory disease where the infection spreads to affect the uterus and fallopian tubes. This may manifest as lower abdominal pain and fever.

Rapid STD Test for Chlamydia and Gonorrhoea PCR is available in all our clinics in Singapore – Next Day STD Results

(Detect the DNA of both Chlamydia and Gonorrhoea in real-time)

Trichomonas (Trichomoniasis)

Trichomoniasis is a genital STD caused by a parasite called Trichomonas vaginalis. Symptoms usually surface several days up to a month after initial infection.

In Men:

  • Discomfort or irritation or an itching sensation in the urine tract
  • Painful urination
  • Penile discharge

In women:

  • Abnormal vaginal discharge (classically described as “frothy green discharge”, sometimes with a foul odour)
  • Vaginal itching
  • Spotting in between menstrual periods
  • Bleeding after intercourse
  • Painful intercourse

Rapid Trichomonas PCR Testingis available in all our clinics in Singapore – Next Day STD Results

Mycoplasma spp and Ureaplasma spp

Certain strains of Mycoplasma (e.g. Mycoplasma hominis, Mycoplasma genitalium) and Ureaplasma (e.g. Ureaplasma urealyticum, Ureaplasma parvum) are bacterial STDs which typically affect the genital tract.

See: Mycoplasma Genitalium Screening & Treatment

In Men:

  • Painful urination
  • Discomfort or irritation in the urine tract
  • Penile discharge

In women:

  • Abnormal vaginal discharge and discomfort
  • Abnormal bleeding/spotting between menses or after intercourse
  • Mycoplasma genitalium specifically: may be associated with increased risk of pelvis inflammatory disease and resultant infertility due to scarring. There is also some evidence to suggest pre-term delivery may occur in pregnant women

Syphilis

Syphilis is caused by a bacteria called Treponema pallidum. Because it is an infection with different stages, it may manifest with a variety of symptoms. These symptoms can sometimes be so mild or unnoticeable that they may be dismissed, which is why syphilis is often diagnosed incidentally on screening (through a blood test).

If left untreated, the infection can spread to involve multiple organs including the brain, eye, nerves and heart.

The symptoms of syphilis are similar in both males and females and can manifest anytime from weeks to months or even years after initial infection.

Syphilis can also cause general symptoms like fever, enlarged lymph nodes, sore throat, which may be incorrectly attributed to other causes.

Primary syphilis

(manifests a few weeks up to 3 months after infection)

  • Painless ulcer is known as a “chancre” – either on the genital, anal or oral region. This may disappear and heal as the infection progresses

Secondary syphilis

(manifests months or more after initial infection)

  • Rash – reddish or brownish patches, anywhere on the body and can affect the palms and soles. This rash may come and go
  • Ulcers in the mouth or genital region
  • Raised greyish patches of skin in the moist areas of the body like the groin or armpits – known as “condylomata lata”

Tertiary syphilis

this list is non-exhaustive and symptoms depend on the organ affected.

  • If the brain is affected, numbness, weakness, incoordination and dementia can occur
  • Heart problems can arise if syphilis causes inflammation of the aorta and associated aortic valve (aortitis)

Latent syphilis

this is when an infected individual has NO symptoms but the disease can progress to tertiary syphilis with devastating consequences.

Neurosyphilis

When syphilis affects the eye and nervous system – can occur anytime, and result in visual problems and even blindness.

Rapid Syphilis Testing is available in all our clinics in Singapore – Results in 20 mins

Herpes

Herpes is caused by the Herpes Simplex Virus type 1 or type 2 (HSV-1 or HSV-2). It is a common STD and can be spread through bodily secretions like saliva or genital fluids. Once infected, individuals may experience flares or outbreaks of herpes from time to time. In between flares, they are asymptomatic. These outbreaks occur typically in the oral, genital or anal region.

The symptoms of herpes are similar in both males and females.

In men & women

Symptoms of herpes occur only during a flare or outbreak

  • Prodromal stage – a vague tingling or discomfort may occur over the skin
  • Stage 2 – nonspecific red spots appear over the skin
  • Stage 3 – these red spots turn into painful, fluid-filled blisters which may resemble tiny pimples
  • Stage 4 – the blisters burst and form painful, shallow ulcers
  • Stage 5 – the ulcers crust and scab over and heal

The first flare of herpes after the initial infection is typically the worst and may even be associated with fever, fatigue and swollen lymph nodes.

Many individuals with HSV have NO symptoms whatsoever and may not even be aware that they carry the virus. Even when absolutely asymptomatic, they can still transmit the virus to others.

(The symptoms of herpes are similar in both males and females)

Rapid Herpes Testing is available in all our clinics in Singapore – Next Day Results

HPV (human papillomavirus)

Human Papilloma Virus (HPV) is a very common STD. Most people who are sexually active are likely to be exposed to various strains of HPV at some point in their lives. Most HPV infections are asymptomatic and infected individuals can still spread the virus to their sexual partners.

Different strains of HPV are associated with various cancers or genital warts or warts.

In men & women

Symptoms of HPV in both men and women:

  • Genital warts – flesh coloured, cauliflower-like bumps or lumps can occur around the genital and perianal region. In women, these can grow outside on the vulva or perianal region, or inside the vaginal canal and on the cervix. In men, these can occur anywhere on the penis, the groin, and the perianal region
  • HPV related oral or anal cancers can occur in both men and women

In women

Symptoms of HPV in women:

  • Certain high-risk types of HPV can result in pre-cancerous or cancerous changes in the cervix. This may cause abnormal spotting or bleeding after intercourse or in between menses, but may have no symptoms and only be detected in an abnormal PAP smear.

HIV Proviral DNA Tesing is available in all our clinics in Singapore. Anonymous HIV Testing is only available in our Robertson Walk clinic.

HIV

HIV stands for Human Immunodeficiency Virus. HIV is often the first and most dreaded STD that people think about. HIV infects the body’s immune system. Over time, it reduces the number of immune cells in the body, leading to a state of weakened immunity where individuals are susceptible to unusual and severe infections as well as cancers.

The symptoms of HIV are widely variable, depending on the stage of infection. Not everyone will experience the same symptoms. Many individuals infected with HIV may have no symptoms whatsoever.

Symptoms of early HIV infection

(several weeks after infection)

  • These symptoms are due to seroconversion i.e. your body’s immune response to having detected the virus
  • Flu-like symptoms with high fever, swollen lymph nodes, sore throat, rash, muscle aches
  • NOT EVERYONE experiences these symptoms; some people can be infected and completely skip this phase

Symptoms of chronic HIV infection

  • There may be NO SYMPTOMS for years after initial infection as the virus silently multiples in the body

Learn more:

Symptoms of AIDS (Acquired Immunodeficiency Syndrome)

The bulk of these HIV symptoms are due to unusual infections which can occur because of a severely weakened immune system. The following list is not exhaustive.

  • Rapid unexplained weight loss
  • Fevers and night sweats
  • Fatigue
  • Swollen lymph nodes
  • Chronic diarrhoea
  • Recurrent yeast (candida) infections
  • Unusual lung infections (e.g. pneumocystis carinii pneumonia)
  • Unusual skin cancers (e.g. Kaposi’s sarcoma)
  • Neurological problems like memory loss or nerve problems

Also Read: 10 Common HIV Related Opportunity Infection

The bottom line is that there are no tell-tale symptoms of HIV infection. The only way to know is to get tested. Early diagnosis is crucial for early treatment, which in turn enables people with HIV to live normal and healthy lives.

Learn more: How to get an Anonymous HIV Test in Singapore

Anonymous HIV Testing is available in our Dr Tan & Partners (DTAP) @Robertson branch.

Under the Anonymous HIV Screening Programme, any local or foreign individual may walk-in to Dr. Tan & Partners @Robertson and request for an HIV screening without providing personal information such as Name, NRIC, Passport Numbers, Address or any form of Contact details.

Asymptomatic STDs

Certain blood borne STDs like Hepatitis B and Hepatitis C may have no symptoms. Hepatitis B and Hepatitis C infect the liver and cause chronic inflammation. Infected individuals may feel perfectly fine for years.

Blood tests for liver function may show some inflammation during this time. Actual symptoms may only manifest much later on in the form of symptoms of end-stage liver disease when the damage to the liver is extensive enough.

Cytomegalovirus (CMV)

Cytomegalovirus (CMV) is an extremely common virus that belongs to the herpes virus family.

An infected individual can transmit the virus during periods of activation – when it is not adequately suppressed by one’s immune system. CMV is transmitted through sexual contact, saliva, urine, and vertical transmission from mother to infant before or during birth, or through breastfeeding.

Infected individuals carry the virus lifelong but it remains suppressed by the immune system in healthy individuals and they have no long term health complications. CMV can cause symptoms and potentially dangerous, even life-threatening illness and complications in individuals with weakened immune systems, such as infants whose immune systems are not fully developed, or individuals on immunosuppressive or chemotherapy and individuals with poorly controlled HIV.

During the initial infection, some individuals may experience symptoms of:

  • Fever
  • Fatigue
  • Myalgia (muscle ache)
  • Swollen lymph nodes
  • Sore throat

In immunocompromised individuals, CMV can affect and cause symptoms involving various organs:

  • Eye
  • Liver (hepatitis)
  • Gastrointestinal tract (oesophagus, stomach, intestines)

In symptomatic adults, antibody blood tests can be used to diagnose CMV infection. For infants with CMV, a urine or saliva sample is usually used to test for infection. Healthy individuals with no symptoms do not require any treatment for CMV. However, in immunocompromised individuals who develop symptoms or in cases of congenital CMV infection, anti-viral medications can be used to treat and suppress the virus.

Molluscum Contagiosum

Molluscum contagiosum is a fairly common skin infection or condition caused by a virus called Molluscum contagiosum, a type of poxvirus. It manifests as raised, pearly, flesh or skin coloured bumps which may sometimes have a central dimple (known as “central umbilication”).

Molluscum contagiosum is spread through skin contact with the virus. Both children and adults alike can be infected by the virus. It spreads when you come into direct contact with someone else’s molluscum lesions, be it through sexual contact, or during contact sports like wrestling. Unfortunately, the virus can survive on surfaces outside the body and can remain on infected surfaces like clothing, towels, gym equipment etc.

Molluscum contagiosum is a benign and self-limiting condition. However, scratching lesions can result in scarring or secondary bacterial skin infections.

Molluscum contagiosum is diagnosed clinically.

Treatment is recommended for:

  • Lesions around the genital or perianal region
  • If lesions are large
  • In immunocompromised individuals with extensive lesions

Various treatment methods available include:

  • Physical removal of lesions – with laser removal or cryotherapy (freezing with liquid nitrogen)
  • Topical creams or ointments
  • In immunocompromised individuals, usual treatment methods may fail and specific, special treatments (e.g. intralesional interferon) may be required.

Chancroid

Chancroid is a sexually transmitted infection caused by the bacterium Haemophilus ducreyi. It is a highly contagious but curable disease. Chancroid is one of the causes of genital ulcer diseases, which includes Herpes Simplex Virus (HSV) Type 2, Syphilis and Lymphogranuloma Venereum (LGV). There is no direct association, but any form of STD can increase your risk of contracting another STD, including Chancroid. Genital ulcer diseases are concerning as their presence greatly increases the risk of HIV transmission.

Symptoms typically begin 4 to 10 days after sexual exposure.

Symptoms include:

  • Developing a small, red pustule on the genitals that breaks down within a day or two to form a painful, soft ulcer with irregular borders
  • Infected men develop a solitary ulcer
  • Infected women usually develop 4 or more ulcers
  • Lymph node swelling in the groin

Other symptoms include:

  • Rectal bleeding
  • Pain with bowel movements
  • Vaginal discharge
  • Painful urination (women)
  • Pain during sexual intercourse (women)

Diagnosis is made based on clinical judgement. According to the US Centres for Disease Control and Prevention (CDC), a probable diagnosis can be made if: 

  1. There is presence of one or more painful genital ulcers
  2. The presentation and appearance of the genital ulcers and, if present, enlarged groin lymph nodes are typical for Chancroid
  3. There is no evidence of syphilis infection on testing of the ulcer, or from blood test performed at least 7 days after onset of ulcers
  4. Swab testing of the ulcer for Herpes Simplex Virus is negative

Appropriate treatment of Chancroid cures the infection, reduces the complications, and prevents transmission. Treatment should be started as soon as a diagnosis of Chancroid is suspected due to the lack of appropriate fast and accurate laboratory testing.

Lymphogranuloma Venereum (LGV)

Lymphogranuloma venereum (LGV) is an uncommon sexually transmitted disease (STD) caused by Chlamydia trachomatis.

Lymphogranuloma venereum (LGV) occurs in 3 stages:

  1. In the first stage, LGV presents with self-limited genital ulcers which may appear anywhere from 3 days to 1 month after exposure. This may be small and/or painless and may be missed by the patient. It may even look like a herpes infection.
  2. In the second stage, the patient usually presents with painful lymph node swelling in the inguinal and/or femoral groups of lymph nodes, usually appearing 2-6 weeks after exposure. The second stage may be associated with back painjoint paininflamed eyescardiac inflammationlung inflammation or liver inflammation if the bacteria disseminate from the local area of infection.
  3. In the last stage, patients with LGV may present with rectal ulcerations and symptoms of inflammation of the rectum which include bloody purulent anal dischargerectal pain and the feeling of incomplete evacuation after passing stools. (More common in patients participating in receptive anal intercourse.)

Lymphogranuloma venereum (LGV) is one of the causes of genital ulcer diseases that includes other STDs, such as Herpes Simplex Virus 2, Syphilis, and Chancroid. Any other form of STDs increases your risk of contracting another STD, including LGV. Not all subtypes of Chlamydia cause LGV.

LGV is almost exclusively transmitted through sexual contact. Infection occurs after direct contact with the skin or mucous membranes of an infected partner.

Laboratory diagnosis ultimately depends on detecting Chlamydia in the lesions/ulcers. We can do a swab test of any lesions and do a urine test to see if Chlamydia is present or not.

Treatment options for LGV – it can be treated with antibiotics. However, a longer course has to be given (3 weeks). Your doctor will choose the appropriate antibiotic for you.

Hepatitis C

Hepatitis C is a liver disease caused by the hepatitis C virus, a highly infectious, bloodborne virus. It can cause both acute (short term) and chronic (long term, persistent) liver inflammation which can range from very mild with no symptoms to severe and life/organ threatening.

The different stages of Hepatitis C infection and their associated symptoms:

Acute hepatitis C

  • Symptoms may begin 2 weeks to several months after initial infection
  • Most individuals may not have any symptoms whatsoever but if a liver function test is done, it may show evidence of liver inflammation (elevated liver enzymes)
  • Individuals who do develop symptoms may experience fever, fatigue, jaundice (yellowing of the skin and eyes), tea-coloured urine, nausea, right sided abdominal pain, joint pains

Chronic hepatitis C

  • In 75-85% of infected individuals, the hepatitis C infection persists long term
  • Most individuals with chronic hepatitis C do not have symptoms but liver function blood tests may show evidence of ongoing liver inflammation
  • About 10-20% of individuals with chronic hepatitis C will develop liver cirrhosis (scarring of the liver with possible impaired liver function)
  • Individuals with cirrhosis may not show any symptoms until advanced stages of cirrhosis
  • Individuals with hepatitis C and cirrhosis are at increased risk of liver failure and liver cancer

It is important to note that a lot of infected individuals have NO SYMPTOMS during both the acute infection and chronic phase.

Certain groups of people may be at increased risk of hepatitis C. These include:

  • Individuals who abuse drugs (inject/snort etc)
  • Individuals who engage in sexual activity that poses an increased risk of exposure to blood e.g. anal intercourse
  • Individuals with partners who have hepatitis C
  • Individuals with HIV
  • Individuals who are or were previously incarcerated
  • Children of mothers with hepatitis C

Hepatitis C infection is diagnosed through blood tests.

Treatment of hepatitis C is only offered for chronic hepatitis C. The good news is that the current anti-viral treatment options for hepatitis C have a high cure rate of >90%. Infected individuals will also need regular follow-ups to monitor for liver inflammation and complications like liver cirrhosis and cancer.

There is unfortunately no vaccine available for hepatitis C. The only hepatitis virus vaccines available are against hepatitis A and B.

Hepatitis B

Hepatitis B is an infection of the liver caused by a virus called Hepatitis B virus. It can cause an acute infection which sometimes results in the person becoming a carrier. Locally, 6% of the Singapore population are hepatitis B carriers. Those who test positive for hepatitis B for more than 6 months after the first test, are diagnosed as chronic. Hepatitis B (HBV) does not spread through the sharing of food, water, utensils, breastfeeding, hugging, kissing, hand holding, coughing, or sneezing.

How does one get infected with Hepatitis B?

  • Sex with an infected partner
  • Injection drug use that involves sharing needles, syringes, or drug-preparation equipment
  • Birth from an infected mother
  • Contact with blood or open sores of an infected person
  • Needle sticks or sharp instrument exposures
  • Sharing items such as razors or toothbrushes with an infected person

Newly acquired (acute) Hepatitis B (HBV) infections symptoms arise occasionally. The presence of signs and symptoms varies by age.

Symptoms include:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-coloured bowel movements
  • Joint pain
  • Jaundice

Hepatitis B symptoms appear an average of 90 days (range: 60–150 days) after exposure to HBV. If they develop yellowing of the whites of the eye, yellowing of the skin with vomiting, abdominal pain and drowsiness, they should seek medical attention as soon as possible.

Hepatitis B is diagnosed through a blood test looking at the Hepatitis B surface antigen and Hepatitis B surface Antibodies;  a Hepatitis B core antigen is used to distinguish active from past infection.

There is no specific treatment for Hepatitis B; only supportive care. In many cases, chronic Hepatitis B carriers do not need treatment but they will require 6 month follow up with blood tests and/ or ultrasound liver for the rest of their lives. In cases where Hepatitis B carriers require treatment, the treatment may involve immune molecules or antiviral medications.

Hepatitis B is a vaccine-preventable disease. All sexual partners, family and close household members living with a chronically infected person should be tested and vaccinated.

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