STI and Urogenital Infection Symptoms: When to See a Doctor
Sexually transmitted infections (STIs) are not rare, and they are not a sign of a "wrong" lifestyle. According to the WHO, more than 374 million new cases of four curable STIs are recorded worldwide each year: chlamydia, gonorrhoea, syphilis, and trichomoniasis. Many STIs have no symptoms — a person doesn't know they're infected and can pass the infection to a partner. This article is written without judgement: its aim is to provide information that helps people seek help in time.
Chlamydia and mycoplasma: the infections that often have no symptoms
Chlamydia is the most common bacterial STI in the world. By various estimates, 70–80% of women and 50% of men with chlamydia have no symptoms at all. This makes chlamydia particularly dangerous: without treatment it can lead to pelvic inflammatory disease (in women), infertility, and ectopic pregnancy.
When symptoms do occur:
- In women: unusual vaginal discharge; burning on urination; lower abdominal pain; pain during sex; bleeding between periods.
- In men: urethral discharge (clear or whitish); burning on urination; pain or discomfort in the testicles.
Mycoplasma and ureaplasma infections are caused by Mycoplasma genitalium and Ureaplasma spp. Their role in disease is debated: ureaplasma is often part of normal flora. Mycoplasma genitalium is a more significant pathogen, associated with urethritis, cervicitis, and pelvic inflammatory disease. Symptoms are similar to chlamydia.
Diagnosis: PCR test (swab or first-void urine). Treatment: antibiotics (regimen depends on the pathogen). Important: both partners must be treated simultaneously.
HIV: early symptoms and when to test
HIV (human immunodeficiency virus) is a virus that attacks the immune system. Without treatment it leads to AIDS. With modern treatment (antiretroviral therapy), people with HIV live full lives of normal length.
Early HIV symptoms appear 2–4 weeks after infection and resemble flu or mononucleosis (acute retroviral syndrome):
- high fever;
- swollen lymph nodes (neck, armpits, groin);
- sore throat;
- rash on the trunk;
- muscle and joint pain;
- sores in the mouth or on the genitals.
These symptoms resolve on their own within 1–2 weeks. HIV then enters an asymptomatic stage that can last for years. This is why symptoms alone cannot be relied upon — a test is needed.
When to test for HIV:
- unprotected sex with a new partner;
- sharing needles for injecting drugs;
- blood transfusion in a country with high HIV prevalence;
- when planning pregnancy (both partners);
- when symptoms of acute retroviral syndrome appear;
- regularly (once a year) with multiple sexual partners.
Testing window: most modern tests (4th generation, antigen/antibody) reliably detect HIV 4–6 weeks after possible infection. A definitive result is available at 3 months. Testing can be done anonymously at HIV/sexual health clinics.
PrEP (pre-exposure prophylaxis) — taking antiretroviral drugs by people at high risk of HIV. Reduces the risk of sexual transmission by more than 99%. Discuss with an infectious disease specialist or sexual health clinic.
Hepatitis B and C: how they spread and how to check
Hepatitis B is transmitted sexually, through blood (shared needles, unsterilised tattoo and piercing equipment), and from mother to child during birth. An effective vaccine exists. Chronic hepatitis B can lead to cirrhosis and liver cancer.
Symptoms of acute hepatitis B: jaundice (yellowing of the skin and whites of the eyes), dark urine, pale stools, pain in the right upper abdomen, fatigue, nausea. But many people have no symptoms during acute hepatitis B.
Hepatitis C is transmitted mainly through blood (shared needles — the main route). Sexual transmission exists but is less efficient than for hepatitis B. There is no vaccine for hepatitis C, but modern drugs (direct-acting antivirals) cure hepatitis C in more than 95% of cases in 8–12 weeks.
Chronic hepatitis C often has no symptoms for years. Symptoms appear at the cirrhosis stage: fatigue, jaundice, swelling, bleeding.
Diagnosis: blood test for HBsAg (hepatitis B) and anti-HCV (hepatitis C). A positive anti-HCV result should be followed by PCR for viral RNA to confirm active infection.
When to get tested for STIs
Many STIs have no symptoms. Regular testing is the only way to know your status. Recommendations:
- When changing sexual partner — get tested for the main STIs (chlamydia, gonorrhoea, syphilis, HIV, hepatitis B and C) before starting unprotected sex.
- Once a year — with multiple sexual partners or inconsistent condom use.
- When planning pregnancy — both partners.
- When symptoms appear — discharge, burning, sores, or a rash in the genital area — immediately.
- After a high-risk unprotected encounter — don't wait for symptoms.
Standard STI screening includes: vaginal swab for flora (in women), PCR for chlamydia and gonorrhoea, blood test for syphilis (RPR/VDRL), HIV, hepatitis B and C. Depending on the situation, the doctor may expand the list.
Which doctor to see: gynaecologist, urologist, or sexual health specialist
The choice of specialist depends on symptoms and sex:
- Gynaecologist — for women with discharge, lower abdominal pain, cycle irregularities, symptoms of vaginitis or cervicitis.
- Urologist — for men with urethral discharge, burning on urination, or testicular discomfort.
- Dermatovenereologist / sexual health specialist — for sores or a rash in the genital area, suspected syphilis, herpes, or HPV. Also handles diagnosis and treatment of most STIs in both sexes.
- Infectious disease specialist — for HIV, hepatitis, and complex cases.
If you're not sure who to see, start with a GP or use our doctor-routing service. And if you want to understand your symptoms, describe them to our assistant.
Frequently asked questions
Does a condom protect against all STIs?
Condoms significantly reduce the risk of most STIs, but do not provide 100% protection. They offer good protection against HIV, gonorrhoea, chlamydia, and trichomoniasis. They are less effective against infections spread by skin-to-skin contact: herpes, HPV, and syphilis (if the sore is outside the area covered by the condom). Correct and consistent condom use is the cornerstone of STI prevention.
Can STIs be transmitted through oral sex?
Yes. Gonorrhoea, chlamydia, syphilis, herpes, and HPV can all be transmitted through oral sex. HIV transmission through oral sex is much less common than through vaginal or anal sex, but the risk is not zero. Using a condom or dental dam reduces the risk.
What is syphilis and how does it present?
Syphilis is a bacterial infection caused by Treponema pallidum. Primary syphilis: a painless sore (hard chancre) at the site of infection — on the genitals, in the mouth, or in the rectum. The sore heals on its own within 3–6 weeks, but the infection remains. Secondary syphilis (2–8 weeks after the chancre heals): a rash on the body (including palms and soles), swollen lymph nodes, general malaise. Without treatment it progresses to latent and tertiary stages with damage to internal organs and the nervous system. Treated with antibiotics (penicillin).
Should I tell my partner about a positive STI test result?
Yes, and it's important. Your partner may have been infected and needs testing and treatment. Without treating the partner, reinfection is inevitable. It can be a difficult conversation, but it's the responsible thing to do. In some countries, anonymous partner notification services are available through a doctor.
What is HPV and is vaccination recommended?
HPV (human papillomavirus) is the most common STI. Most strains are harmless and clear on their own. Oncogenic strains (16, 18) cause cervical cancer, oropharyngeal cancer, and anal cancer. The HPV vaccine (Gardasil, Cervarix) protects against the main oncogenic strains. It is most effective before sexual activity begins, but is also recommended for adults up to age 26–45 (depending on the country). Discuss with your doctor.
Can herpes be cured?
The herpes virus (HSV-1 and HSV-2) remains in the body for life — there is no complete cure. But antiviral medications (aciclovir, valaciclovir) significantly reduce the frequency and severity of outbreaks and lower the risk of transmission to a partner. For frequent outbreaks, a doctor may prescribe continuous (suppressive) therapy.
Symptomatica is an informational reference service. Not a medical service; does not diagnose or prescribe treatment. For any symptoms, please consult a doctor.