Common STIs: symptoms and treatment

You can have an STI without discharge, sores or pain. When symptoms do appear, they can overlap with other conditions. A test and an assessment by a clinician are more useful than trying to match a symptom to a photograph.

Chlamydia and gonorrhoea

Chlamydia often has no symptoms. Possible signs include burning when peeing, lower tummy pain, and bleeding after sex or between periods. Gonorrhoea can cause yellow or greenish vaginal discharge, burning when peeing or lower abdominal pain.

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

Follow-up testing depends on the infection site, treatment and local guidance. NHS patient information advises a return test to check that gonorrhoea has cleared. US CDC guidance does not routinely require this test of cure after appropriate treatment of uncomplicated genital or rectal infection, but does for throat infection. Later testing for reinfection has a different purpose. Ask your clinic which follow-up you need. Follow the clinic’s instructions about when you and any partners can have sex again.

Syphilis can change over time

Syphilis may begin with a painless sore on the genitals or around the anus. Later, a rash can appear on the palms or soles. Symptoms can disappear even while the infection remains, so a healed sore does not remove the need for assessment.

Syphilis is treated with antibiotics, with follow-up tests as part of your care. Ask the clinic what follow-up is planned and how to contact them if you cannot attend. A partner who has syphilis or another STI is also a reason to arrange a check.

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 or shorten outbreaks, although they do not cure the infection. Your clinician can help you choose a suitable treatment.

Herpes can be passed on without symptoms. A herpes blood test cannot tell when the infection was acquired or who it came from. The timing of a first sore cannot tell you what has happened in a relationship.

Genital warts are small, rough lumps around the genitals or anus. Treatment options include prescribed creams or liquids and freezing. Warts can return after treatment. Do not use ordinary pharmacy wart treatments on genital skin; the NHS says they are not 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 peeing or having sex. Many people have no symptoms. Antibiotics treat the infection, and current and recent partners also need treatment.

When pelvic pain needs urgent care

Pelvic inflammatory disease, or PID, affects the womb, fallopian tubes and ovaries. It can follow chlamydia or gonorrhoea, but other vaginal bacteria can also cause it. Untreated PID can lead to persistent pelvic pain, fertility problems or a higher risk of ectopic pregnancy.

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 pelvic pain, especially with unusual discharge or bleeding between periods.

Go to A&E now (UK), or an emergency department (US and elsewhere), for pelvic pain that is severe, worsening or hurts when you move or touch the area; pelvic pain with heavy vaginal bleeding; or pelvic symptoms with faintness, 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 peeing 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 pregnant, tell your maternity clinician about herpes symptoms or possible exposure.

Before leaving an appointment, ask when you will hear about results and who to contact with questions about the treatment plan.

Condoms reduce the risk of many STIs, but cannot cover all skin affected by herpes. Ask the clinic which tests and treatments you and any partners need, and how you will receive follow-up advice.