The Ultimate Guide to STIs

STI’s are weird. Do we call them STD’s or STI’s? Why does the Google black hole have to be so scary? Maybe I do feel a little itchy now that I think about it? Is my discharge normal? Why am I overthinking this? Why is no one else talking about this? Why is there so much stigma and why is this topic so misunderstood?

Who am I kidding. Almost everything in sex is misunderstood. I just need you, my dear reader, to understand that STIs (I like to call them STIs because they really are just infections, disease sounds so dramatic) are not that big of a deal.

Now you might be thinking, alright Sara if they’re not that big of a deal, why are you writing an entire blog on a guide to STIs. Great question. It’s because I truly believe that this stigma, misunderstanding, and fear we have around STIs stems from a lack of awareness.

The reality of the situation is that one in every two sexually active people will contract an STI by the age of 25. That means around half of the people reading this have already had a run-in with STI’s and, most probably, been confused or scared about their diagnosis until they realized it wasn’t that big of a deal.

“The unfortunate thing about STD ‘education’ is that it focuses on very specific information: symptoms, treatments, and every worst-case scenario. The real-world experiences and probabilities are absent. Down-to-earth guidance on how this information should affect your behavior is usually glossed over — telling you to abstain from having sex (yeah right) and to use a condom (even though it doesn’t prevent everything). As a result, people start getting paranoid and some serious social stigmas develop.” — Mark Manson

Ladies remember that time you got nervous something felt off down there and you pulled out a handheld mirror to inspect what’s going on. Or did some awkward poses in front of your full-length mirror? “Am I swollen on one side or does my labia normally look like that? Wow… now I’m realizing I never look at my vagina. It’s super interesting. Kinda pretty. Aw. Okay focus.”

Symptoms are weird. More often than not they show up differently in everybody, especially people with penises. Most of you won’t even know you have an STI, leaving us humans with vaginas a little more susceptible to your previous choices. This is why I cannot stress enough, male or female, penis or vagina, PLEASE get tested at least once a year. And please do so multiple times a year if you have multiple sexual partners in short amounts of time.

Oh and let’s talk about the STI = dirty debate. Is getting the common cold considered dirty? No, you rest for a few days, drink some tea, and voila, you’re back to normal. The same goes for sexually transmitted infections. That’s what it is, an infection. Most are treatable, some aren’t. And that’s okay because usually, the untreatable ones are pretty easy to live with.

The most important thing to note is that, more often than not, it’s not the end of the world. Time and time again I see people get so bogged down and terrified over the reality of getting a sexually transmitted infection. I get calls from friends, friends of friends, and friends of friends of friends asking if their life is over because of their newly found infection (being the local sexual health advocate has its perks).

Long story short: it’s not. Far from it. The more I learned about STIs, the more I realized that relaxing is the best thing we can do for ourselves. Seriously. Relax. Not only does it help your body’s immune response, but it reminds you that getting an STI is actually an incredibly mild, nonthreatening experience.

Now on to the guide.

I’ve broken it down so it’s easy to use and read in these sections listed below.

  • Infection name and basic info
  • How it’s transmitted / how you get it
  • Symptoms
  • How to treat It

It’s one of our longer blog posts but it’s a great tool to have in your wellness kit. Read it now, or bookmark it and save it for a rainy day. Just know that this is here for you and you can come back to it whenever you need. So without further ado, here are all the STIs you need to know about.

Bacterial Vaginosis

Bacterial vaginosis (BV) is a condition that happens when there are too much of certain bacteria in the vagina. This changes the normal balance of bacteria in the vagina and can cause itchiness, burning, and weird discharge. It’s easy to treat and is more of an inconvenience than anything else.

How you get it

Researchers do not know the cause of BV or how some women get it. We do know that the condition typically occurs in sexually active women. BV is linked to an imbalance of “good” and “harmful” bacteria that are normally found in a woman’s vagina. Having a new sex partner or multiple sex partners, as well as douching, can upset the balance of bacteria in the vagina. This places a woman at increased risk of getting BV.

We also do not know how sex contributes to BV. There is no research to show that treating a sex partner affects whether or not a woman gets BV. But we do know BV rarely affects women who have never had sex.

Symptoms

Many women with BV do not have symptoms. If you do have symptoms, you may notice:

  • A thin white or gray vaginal discharge;
  • Pain, itching, or burning in the vagina;
  • A strong fish-like odor, especially after sex;
  • Burning when urinating;
  • Itching around the outside of the vagina.

How to treat it

A health care provider will examine your vagina for signs of vaginal discharge. Your provider can also perform laboratory tests on a sample of vaginal fluid to determine if BV is present.

BV will sometimes go away without treatment. But if it’s uncomfortable you should be checked and prescribed antibiotics. It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may return even after treatment. Treatment may also reduce the risk of some STIs.

Male sex partners of women diagnosed with BV generally do not need to be treated.

Chlamydia

Chlamydia is a common relatively minor bacterial infection that can infect both men and women and is easily cured with antibiotics. It’s generally harmless to men, but for women, if left untreated, it can cause pelvic inflammatory disease which can lead to complications with pregnancies or even infertility.

How you get it

You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia.

If your sex partner is male you can still get chlamydia even if he does not ejaculate (cum).

If you’ve had chlamydia and were treated in the past, you can still get infected again. This can happen if you have unprotected sex with someone who has chlamydia.

Symptoms

Most people who have chlamydia have no symptoms. If you do have symptoms, they may not appear until several weeks after you have sex with an infected partner. Even when chlamydia causes no symptoms, it can damage your reproductive system.

Women:

  • An abnormal vaginal discharge;
  • A burning sensation when urinating.

Men:

  • A discharge from their penis;
  • A burning sensation when urinating;
  • Pain and swelling in one or both testicles (although this is less common).

Men and women can also get infected with chlamydia in their rectum. This happens either by having receptive anal sex or by spread from another infected site (such as the vagina). While these infections often cause no symptoms, they can cause

  • Rectal pain;
  • Discharge;
  • Bleeding.

How to treat it

Chlamydia can be cured with the right treatment and medication. It is important that you take all of the medication your doctor prescribes to cure your infection. When taken properly it will stop the infection and could decrease your chances of having complications later on. You should not share medication for chlamydia with anyone.

Repeat infection with chlamydia is common. You should be tested again about three months after you are treated, even if your sex partner(s) was treated.

Gonorrhea

Gonorrhea is another bacterial infection that is a little more uncomfortable than chlamydia. Often referred to as “chlamydia’s big brother.” Gonorrhea can take a while to show up and is more challenging to deal with. Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, untreated gonorrhea can cause pelvic inflammatory disease (PID). Some of the complications of PID are

In men, gonorrhea can cause a painful condition in the tubes attached to the testicles. In rare cases, this may cause a man to be sterile, or prevent him from being able to father a child.

How you get it

You can get gonorrhea by having vaginal, anal, or oral sex with someone who has gonorrhea. And a pregnant woman with gonorrhea can give the infection to her baby during childbirth.

Symptoms

Some men with gonorrhea may have no symptoms at all. Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection.

Men:

  • A burning sensation when urinating;
  • A white, yellow, or green discharge from the penis;
  • Painful or swollen testicles.

Women:

  • Painful or burning sensation when urinating;
  • Increased vaginal discharge;
  • Vaginal bleeding between periods.

How to treat it

Since gonorrhea is a bacterial infection, it can be treated with antibiotics. There has been a rise in antibiotic-resistant strains of gonorrhea in the past couple of years. There are only two antibiotics left that can treat it (you have to take them both now, actually), and while the resistant strains are still fairly uncommon, health officials are concerned that it could become an issue in the not-so-distant future.

Herpes

Herpes are “sores” that usually appear as one or more blisters. These symptoms are sometimes called “having an outbreak.” There are two types of Herpes: HSV-1 and HSV-2. HSV-1 usually causes breakouts around the mouth — we just call them cold sores or fever blisters. Over 80% of the population has HSV-1, although at any given time almost none of us have a breakout. HSV-2 causes breakouts around the genitals.

The reality of herpes is that it’s more common to have herpes than to not have herpes. That means… I probably have herpes and you do too. Sounds intimidating but it’s really not. Most people with the virus don’t have symptoms and even without signs of it or ever having an outbreak, they can still transmit it to another person. If you do happen to have an outbreak, it’s still pretty easy to deal with. Most OB-GYNs say that usually their patients only have their initial outbreak and never get it again or they had it for a year or so and never got it again with each outbreak getting more and more minor each time. And if you do happen to get recurring outbreaks, there are medications out there that suppress them.

How you get it

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the disease.

If you do not have herpes, you can get infected if you come into contact with the herpes virus in:

  • A herpes sore;
  • Saliva (if your partner has an oral herpes infection) or genital secretions (if your partner has a genital herpes infection);
  • Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection.

You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.

Symptoms

You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they are infected with HSV-2. The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection stays in the body for the rest of your life, the number of outbreaks may decrease over time.

How to treat it

There is no cure for herpes but there are ways to treat it and make it more manageable. There are medicines and antivirals that can prevent or shorten outbreaks. One of these antivirals can be taken daily and makes it 75% less likely that you will pass the infection on to your sex partner(s).

HPV

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. 79 million Americans, most in their late teens and early 20s, are infected with HPV. The virus is so common that nearly all sexually active people get infected at some point in their lives. There are many different types of HPV. But there are vaccines that can stop these health problems from happening. The good news is, there are more than 200 kinds of HPV and most of them are harmless and go away on their own. Like, so harmless, that most people never know they have it. But when HPV does not go away, it can cause annoyances like genital warts and health issues such as cancer.

How you get it

HPV is spread by skin-to-skin contact with genitals, as well as oral, vaginal, and anal sex. That means it can be spread even if no one cums, even if a condom is used, and even if a penis doesn’t go inside the vagina/anus/mouth — you get the point. So even if you’re not “having sex,” you can still put yourself at risk in those oh so sweet moments of foreplay.

Symptoms

Like we mentioned before, most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening).

How to treat it

There are no treatments for the virus itself, but there are treatments for the health problems that HPV can cause. If you happen to get warts, these can be treated by your doctor by getting them removed, using a topical cream, or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number. Pap smears are also essential to test for any signs of cancer that can be caused by HPV so it can be caught and treated early.

To learn more about HPV and cervical cancer head to our in-depth blog on cervical cancer.

HIV

HIV stands for human immunodeficiency virus. The virus can be transmitted through contact with infected blood, semen, or vaginal fluids. There are some demographics that are far more likely to catch HIV than others, primarily gay men and drug users. 80% of all HIV cases come from gay men or drug addicts who use dirty needles. When it comes to vaginal sex, it’s almost impossible for a man to catch it from a woman, while a woman can catch it from a man. But anal sex seems to be the big culprit here.

The good news is that the life expectancy of HIV has gone up due to modern treatments and awareness. It’s no longer as deathly as it once was. The average life expectancy of someone who contracts HIV is 40 years from the day they contract it. If you need a beacon of hope, just think of Magic Johnson.

How you get it

The virus can be transmitted through contact with infected blood, semen, or vaginal fluids. So not only through unprotected sex, but using dirty needles is also a common transmitter of HIV.

Symptoms

Within a few weeks of HIV infection, flu-like symptoms such as fever, sore throat, and fatigue can occur. Then the disease is usually asymptomatic until it progresses to AIDS. AIDS symptoms include weight loss, fever or night sweats, fatigue, and recurrent infections.

How to treat it

No cure exists for HIV or AIDS, but strict adherence to antiretroviral therapy (ART) can dramatically slow the disease’s progress, prevent secondary infections and complications, and prolong life. There is also a medication people can take called PrEP that is highly effective in for preventing HIV from sex. This is a great option for people who regularly engage sexually with someone diagnosed with AIDS.

Syphilis

Syphilis is an older STI that is not as much of a problem anymore as it was back in the day. It’s pretty rare and your odds of contracting it are pretty low unless you’ve slept with over 1,000 people… It’s simple to cure with the right treatment but there can be serious complications when left untreated. One of those being that you go insane and kill yourself. I wish I was kidding.

How you get it

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth.

Symptoms

Syphilis plays itself out in stages. Primary, secondary, latent, and tertiary.

Primary

  • A sore or sores at the original site of infection. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually (but not always) firm, round, and painless.

Secondary

  • Skin rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed.

Latent

  • No signs or symptoms.

Tertiary

  • 15–20 years later your internal organs start bleeding, you lose control of your motor functions, and you start losing your mind, like our dear Neitzsche.

How to treat it

Syphilis can be cured with the right antibiotics from your healthcare provider. However, treatment might not undo any damage that the infection has already done, which is why it’s so important to be caught early.

If you have any questions on this guide or just need someone to talk to, please do not hesitate to contact me at sara@wearbwr.com or DM our Instagram. As much as we advocate to normalize these conversations, they can be hard to have. If you need a friend to talk to, relate to, or just have someone hear you, b.WR and I are here for you.

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