Common Sexually Transmitted Infection (STI) Symptoms in Females

If you're sexually active, you're at risk of sexually transmitted infections (STIs), previously referred to as sexually transmitted diseases (STDs). Someone with an STI might not show symptoms and could pass the infection on. Even practicing safe sex is no guarantee since condoms aren't foolproof against STIs.

"Not all cases of every STI are symptomatic," Christine Greves, MD, an OB-GYN at the Winnie Palmer Hospital for Women & Babies, told Health. In fact, most people with herpes, chlamydia, or gonorrhea do not levelly any symptoms.

Also, even when people develop symptoms, it can be easy to mistake them for another condition, like a yeast infection or urinary tract infection (UTI).

So, if you're sexually active and something feels off, what you're feeling could be an STI symptom. The Centers for Disease Control and Prevention (CDC) reports that one in five people in the United States has an STI.

What STI symptoms should you be concerned about? Here are the seven of the most common symptoms of STIs in people assigned female at birth.

STI Symptoms in Females

Symptoms of different STIs tend to overlap. So, one having one symptom isn't usually definitively diagnostic of a particular STI. 

Also, keep in mind that having one of these symptoms doesn't automatically mean you have an STI. Your symptom could be something else, like a skin condition.

Burning Sensation With Urination

If you feel a burning sensation when you try to pee or while peeing, it's more likely you have a UTI than an STI. Still, an STI could be to blame. 

"This is probably the most common symptom that we see with STIs," Michael Angarone, DO, an associate professor in the division of infectious diseases at the Northwestern University Feinberg School of Medicine, told Health.

The pain comes from inflammation in your urinary tract. Bacteria can cling to the mucus membranes of the urethra, which is the tube pee comes out of, causing inflammation.

As a result, "you may get a lot of burning when you urinate and go to the bathroom a lot," said Dr. Angarone. STIs like chlamydia, gonorrhea, and trichomoniasis ("trich") can be the root cause.

Still, burning with urination is more likely to be a symptom of a UTI than an STI. So, consulting a healthcare provider to figure out the cause is essential.

Unusual Vaginal Discharge

You may notice your discharge changes in color and consistency, especially during your menstrual cycle. When you're ovulating, discharge usually appears clear and stretchy. Before your period starts, discharge may have a yellow tinge and be thick. 

In contrast, discharge with itching, redness, swelling, pelvic pain, or a strong smell may indicate an STI, like trich, chlamydia, or gonorrhea. You may also notice blood in your discharge. 

Abnormal discharge links to inflammation. When bacteria clings to your reproductive tract, you may have irritation and an unusual discharge, explained Dr. Angarone.

Abnormal Vaginal Bleeding

Bleeding when it's not that time of the month or after sex could be alarming, and an STI can be to blame. 

"High-risk human papillomavirus [HPV] could affect the cervix, which can cause bleeding after sex," said Dr. Greves.

Inflammation in your reproductive tract can irritate the mucus membranes of your vagina and cause bleeding, explained Dr. Angarone.

In general, bleeding from an STI tends to be described as spotting. People rarely notice a large amount of blood, like you would see when you have your period.

Burning or Itching Sensation of the Vagina

Vaginal itching and burning, also known as vaginitis, are the telltale signs of a yeast infection. However, STIs can also cause those symptoms. For example, trich can cause vaginitis. With trich, in addition to vaginal itching and burning, you may notice symptoms like:

• Yellow-green or gray vaginal discharge
• Pain during or after sex
• Vaginal odor
• Pain while urinating

"The vaginal tissue is just more sensitive if you have an STI," said Dr. Greves. "It becomes inflamed, and the normal protective mechanisms may be disrupted."

Vaginal Pain During Sex

Painful sex is a tip-off that something isn't right. STIs like chlamydia and gonorrhea can result in painful sex because of vaginal inflammation, said Dr. Greves.

Herpes can also lead to painful intercourse. Lesions can form in your vagina and on your cervix. During sex, those lesions can become irritated and inflamed.

Bumps On and Around the Vagina

If you develop a bump, sore, or wart, don't write it off, even if it goes away after a few days. Bumps may signify several STIs.

For example, certain strains of HPV cause genital warts, which are flesh-colored. Genital warts can be flat or bumpy and look like cauliflower. In some cases, genital warts are so small that you may not notice them.

Also, conditions like herpes will have flares of small red blisters that come and go. In fact, people with herpes often have several flares per year. However, when sores aren't visible, you can still spread the virus, said Dr. Greves. 

Pelvic Pain

Just like painful sex, pelvic pain is a sign to pay attention to. Chlamydia and gonorrhea are known to cause pelvic pain. 

"Chlamydia and gonorrhea can contribute to pelvic pain because they can affect the vagina and also spread to the uterus and fallopian tubes," said Dr. Greves.

In particular, chlamydia and gonorrhea increase your risk of pelvic inflammatory disease (PID) if untreated. PID is an infection of the uterus and fallopian tubes that causes lower abdominal pain. Also, PID may cause pain and bleeding when you have sex and an unusual discharge with a bad odor.

Nearly 85% of PID cases are due to STIs, and about 10% to 15% of women with chlamydia or gonorrhea develop PID.

Timing of STI Symptoms

The timing of when you start to notice symptoms after exposure depends on the infection, such as:

• Chlamydia: Symptoms can show up several weeks after infection.
• Gonorrhea: Symptoms may develop between one to 14 days after infection.
• Herpes: Symptoms may develop about two to 12 days after exposure. A first flareup can happen months and years after you were initially exposed, said Dr. Greves.
  

Location of STI Symptoms

STI symptoms typically show up on the genitals. However, you can also get symptoms all over your body, "really, anywhere near and far from the site of infection," Kjersti Aagaard, MD, a professor of obstetrics and gynecology at the Baylor College of Medicine, told Health. For example, symptoms may occur in the mouth from oral sex.

Also, herpes and human immunodeficiency virus (HIV) can also cause a fever, chills, and other flu-like symptoms.

"There are even situations where STIs, such as gonorrhea, can cause rheumatoid symptoms in the joints, and syphilis can infect the brain to cause symptoms," added Dr. Aagaard.

Treatments for STIs

If you were recently sexually active and have signs of an STI, consult a healthcare provider immediately, advised Dr. Aagaard. While your symptoms could be due to something else, they also could be an STI. So, you don't want to sit on that.

"As soon as you feel symptoms, pick up the phone and get an appointment," advised Dr. Greves.

Treatments depend on the type of STI and may include oral or topical antiviral or antibacterial medications. A healthcare provider can recommend the best treatment after performing laboratory tests and diagnosing your symptoms.

Even if you do not have STI symptoms but were recently exposed to an STI, seeing a healthcare provider is still essential.

Untreated STIs

STIs can lead to serious complications, including permanent damage to your reproductive system. In some cases, that damage can make it difficult to become or stay pregnant.

For example, chlamydia can raise your risk of having an ectopic pregnancy. An ectopic pregnancy is a life-threatening pregnancy that happens outside the uterus.

Also, undiagnosed and untreated STIs raise your risk of spreading the infection to others. 

"The sooner you get [your symptoms] evaluated, the less likely you are to pass it on," said Dr. Angarone.

A Quick Review

Often, STIs present similarly to other infections, like yeast infections or UTIs. So, if you've recently been sexually active and notice abnormal discharge, vaginal bleeding, or pelvic pain, among other symptoms, consulting a healthcare provider may be helpful.

Practicing safe sex is key to preventing the spread of STIs. Condoms help lower your risk of becoming infected and spreading infections.