Play It Safe: Sexually Transmitted Diseases Are on the Rise

An STD, also known as a sexually transmitted infection or STI, is passed from an infected person, usually unknowingly, to an uninfected person during sex, but it can also spread whenever there is bodily fluid exchange.

Chlamydia, gonorrhea and syphilis are bacterial infections that can be spread simply by touching an infected area. It isn’t necessary for a man to ejaculate in order to pass the infection to his partner. Many people infected with these diseases may not know it, which increases the risk of spreading.

“These infections often have minimal or no symptoms in their early stages,” says Varinthrej Pitis, MD, an internal medicine physician at Scripps Clinic Carmel Valley. “Without treatment, persistent or inappropriately treated infections can lead to serious complications, including pelvic inflammatory disease, infertility, neurological consequences, joint problems and congenital birth defects.”

STDs are also caused by viruses, including HIV, human papillomavirus (HPV), hepatitis B and herpes.

While anyone who is sexually active can get an STD, the people most affected are young people between the ages of 15 to 24, gay, bisexual and other men who have sex with men, pregnant people and people from racial and ethnic minority groups. The CDC provides STD screening recommendations for these groups.

Follow these precautions to help reduce your risk of STDs:

• Use condoms correctly every time you have sex.
• Limit sexual contact to one uninfected partner.
• Get tested for STDs when you have a new partner or if you have symptoms.
• Avoid sex with someone who has symptoms or has several partners.

The following are commonly asked questions about chlamydia, gonorrhea and syphilis:

The number of syphilis cases is on the rise. In 2022, there were 207,255 reported cases, the highest number since 1950, according to the CDC.

Rates have been going up for gay, bisexual and other men who have sex with men. Rates of syphilis among women have increased since 2013.

Syphilis can be spread through sexual activity, kissing, or bodily contact with skin sores that develop in the early stages of the disease.

Syphilis has four stages.

Primary (early) syphilis causes small, painless sores on the genitals or mouth between 10 to 90 days after exposure. Because the sores are painless, most people who are infected are not aware. The sores heal within six weeks even without treatment, but the person is still infected and contagious.

Secondary syphilis starts six weeks to six months after exposure and causes a copper-colored rash on the palms of the hands and soles of the feet, along with body rashes. Other symptoms may include moist warts in the groin, white patches inside the mouth, swollen lymph glands and fever. Secondary syphilis symptoms also go away without treatment.

The latent stage of syphilis shows no symptoms. Without treatment, syphilis can remain in your body for many years without showing any signs.

Tertiary syphilis is rare and can appear many years after an infection. It can affect the heart, brain and nerves and cause dementia, paralysis, blindness, hearing loss and impotence. Without treatment, syphilis can be fatal.

Treatment for syphilis usually involves one or more doses of antibiotics.

If syphilis is not treated, it can cause serious problems, including brain and nerve problems, eye problems and even blindness.

Babies who contract congenital syphilis (passed from mother to baby during pregnancy) may be stillborn or die shortly after birth. Others may have developmental delays, seizures, deafness or other significant health problems.

In 2022, 3,755 cases of congenital syphilis were reported, up from 2,875 in 2021.

Chlamydia is the most commonly reported STD in the U.S. In 2022, there were 1.65 million reported cases. This is slightly lower than the previous year.

Chlamydia is most common in young people. Almost 60% of chlamydia cases occur in people aged 15 to 24.

Chlamydia is often a silent infection. Most people with chlamydia have no symptoms or abnormal physical exam findings. Screening is necessary to identify most infections.

Women who have symptoms may notice the following:

• Unusual vaginal discharge, itching or burning
• Bleeding between periods
• Painful periods
• Abdominal pain with fever
• Pain during urination or sex

Chlamydia symptoms in men may include:

• Clear or cloudy discharge from the penis
• Burning and itching at the tip of the penis
• Pain and swelling around the testicles
• Pain during urination

Other symptoms may include:

• Rectal itching, mucus-like rectal discharge and spots of bright red blood on toilet tissue
• Painful rectum during bowel movements
• Sore throat and swollen lymph nodes in the neck

Most cases of chlamydia are treated successfully with antibiotics.

“With all of these diseases, your partners need to also be treated to prevent reinfection and spreading the diseases further,” says Dr. Pitis. “If you are exposed to the bacteria again after being treated, you can still develop a recurrent infection.”

Untreated chlamydia can cause pelvic inflammatory disease in women, which can lead to infertility. Antibiotics cannot treat damages that have already been done by the infection, such as scar tissue from an infection that can lead to infertility.

In pregnant women, it may increase the risk of premature birth, premature rupture of membrane, or ectopic pregnancy, which means the fertilized egg develops outside of the uterus. Infected babies may develop an eye infection or pneumonia.

In men, untreated chlamydia can lead to infection of the urethra or epididymis (the tube that carries sperm from the testes).

Gonorrhea is the second most commonly reported STD. In 2022, there were 648,056 reported cases of gonorrhea, which was 8.7% lower than the year before. The number of cases is up 11% since 2018, however.

Pregnant women can also pass gonorrhea to their newborn babies.

Gonorrhea often has no symptoms but can still cause serious health problems.

Symptoms in women may include:

• Increased vaginal discharge
• Painful urination or intercourse
• Vaginal bleeding between periods
• Abdominal or pelvic pain

Symptoms in men may include:

• Painful urination
• Discharge from the penis
• Pain or swelling in a testicle

Symptoms also may include:

• Rectal itching, pus-like discharge and spots of bright red blood on toilet tissue
• Eye pain, pus-like discharge from one or both eyes and sensitivity to light
• Sore throat and swollen lymph nodes in the neck
• Warm, red, swollen and extremely painful joints

Gonorrhea is treated with different antibiotics due to its rising resistance over the years.

Without appropriate treatment, gonorrhea complications are similar to chlamydia. In women, it may cause pelvic inflammatory disease, infertility and increase the risk of HIV infection. In men, it can result in epididymitis, which causes pain and swelling in the testicles.

In addition, bacteria can spread through the bloodstream, infecting the joints, heart valves, bone and brain, and causing fever, skin sores and rash.

Babies who contract gonorrhea during childbirth may have serious vision problems and infections.