Common STIs: symptoms and treatment

You can have an STI (sexually transmitted infection) without any discharge, sores or pain. When symptoms do appear, they can look like other conditions. A test and a check by a clinician are more useful than trying to match a symptom to a photo.

Chlamydia and gonorrhoea

Chlamydia often has no symptoms. Possible signs include burning when you pee, pain low in your tummy, and bleeding after sex or between periods. Gonorrhoea can cause yellow or greenish discharge from the vagina, burning when you pee, or pain low in your tummy.

Both infections are treated with antibiotics. The medicine and follow-up depend on the infection, so ask your GP, doctor or sexual health clinician for advice.

Follow-up tests depend on where the infection was, the treatment and local guidance. NHS patient information advises coming back for a test to check that gonorrhoea has gone. After the right treatment for uncomplicated genital or rectal infection, US CDC guidance doesn’t usually require this test. It does for a throat infection. Testing later to check you haven’t caught it again is a different thing. Ask your clinic which follow-up you need. Follow the clinic’s advice on when you and any partners can have sex again.

Syphilis can change over time

Syphilis may start with a painless sore on the genitals or around the anus. Later, a rash can appear on the palms of the hands or soles of the feet. Symptoms can go away even while the infection is still there. So a sore that has healed doesn’t mean you no longer need a check.

Syphilis is treated with antibiotics, and follow-up tests are part of your care. Ask the clinic what follow-up is planned and how to contact them if you can’t make it. If a partner has syphilis or another STI, that’s also a reason to get checked.

Herpes and genital warts

Genital herpes can cause blisters that break into painful sores. Many people have very mild symptoms or none. Antiviral medicines can prevent outbreaks or make them shorter, but they don’t cure the infection. Your clinician can help you choose a treatment that suits you.

Herpes can be passed on without symptoms. A herpes blood test can’t tell when you caught it or who it came from. The timing of a first sore can’t tell you what has happened in a relationship.

Genital warts are small, rough lumps around the genitals or anus. Treatments include prescribed creams or liquids, and freezing. Warts can come back after treatment. Don’t use ordinary wart treatments from a pharmacy on genital skin. The NHS says they aren’t made for genital warts.

Trichomoniasis may cause discharge or irritation

Trichomoniasis (sometimes called trich) can cause yellow-green discharge that is frothy or smells fishy, irritation, and pain when you pee or have sex. Many people have no symptoms. Antibiotics treat the infection, and current and recent partners need treatment too.

When pelvic pain needs urgent care

Pelvic inflammatory disease (PID) affects the womb, fallopian tubes and ovaries. It can follow chlamydia or gonorrhoea, but other bacteria in the vagina can also cause it. If PID isn’t treated, it can lead to pelvic pain that won’t go away, fertility problems or a higher risk of ectopic pregnancy (a pregnancy outside the womb).

Contact an urgent GP service or NHS 111 today in the UK, or your doctor or urgent care service in the US and elsewhere, for pain in your pelvis, especially with unusual discharge or bleeding between periods.

Go to A&E now (UK), or an emergency department (US and elsewhere), for pain in your pelvis that is severe, getting worse, or hurts when you move or touch the area. Do the same for pain in your pelvis with heavy vaginal bleeding, or symptoms in your pelvis with feeling faint, a very high temperature, feeling hot, cold or shivery, nausea, vomiting or feeling very unwell.

Getting care and preventing infection

For genital sores, discharge, burning when you pee or a partner with an STI, contact a sexual health clinic or GP in the UK, or a doctor or sexual health clinic elsewhere. If you’re pregnant, tell your maternity clinician about any herpes symptoms or possible exposure.

Before you leave an appointment, ask when you’ll get your results and who to contact with questions about your treatment.

Condoms lower the risk of many STIs, but they can’t cover all the skin that herpes can affect. Ask the clinic which tests and treatments you and any partners need, and how you’ll get follow-up advice.