Sexually Transmitted Infections

More commonly known as sexually transmitted diseases (STDs), sexually transmitted infections (STIs) carry a heavy burden of disease for women. The World Health Organization (WHO) recommends that the term STI replace the term STD, as it better reflects the asymptomatic nature of most infections.

Genital human papillomavirus (HPV) is the most common STI, with more than 40 types that can affect [Page 1338]the skin of the genitals. Most do not develop symptoms, and untreated HPV in women can cause cervical cancer, genital warts, and cancers of the vulva, vagina, and anus. HPV is transmitted through vaginal and anal sexual contact. Preventing HPV-related diseases includes regular cervical cancer screenings and pap exams. There is also now a vaccine for girls aged 11 through 26 years to reduce the risk of developing certain types of HPV and cervical cancers. There is no such vaccine for men yet.

Gonorrhea is the second most common STI in the United States. Chlamydia and gonorrhea commonly co-occur but are separate infections. Also known as “silent” STIs because a majority of women never experience symptoms, both gonorrhea and chlamydia can cause painful urination and pain during sexual activity; bleeding between periods; itching of the genital area; a foul odor; and white, yellow, or green discharge. They are often mistaken for a vaginal infection. Symptoms usually appear one to three weeks after infection. In 2008, the rates for women were 119.4 compared with men at 103.0 cases per 100,000. Among all women in 2008, those aged 15 to 24 years had the highest rates. Both chlamydia and gonorrhea, if left untreated, can lead to pelvic inflammatory disease (PID), which can later lead to serious health problems for women such as tubal infertility, ectopic pregnancy, and chronic pelvic pain. One million women develop PID annually.

Caused by two different viruses (HSV-1, which often causes sores around the mouth and lips, and HSV-2 which causes genital sores), the herpes simplex virus (HSV; genital herpes) is untreatable but manageable. Often appearing as one or more sores on or around the genitals or rectum, the blisters break open, leaving painful open sores may take two weeks to a month to heal and often lay dormant until another cyclical outbreak. Symptoms can also be flulike and include swollen glands and feverishness. HSV is transmitted from these open sores and from skin that does not appear to have a sore, but most people are unaware of their infection. Genital HSV-2 is almost two times more common in women than men.