What Does An STD Look Like?

Vaginal discharge is one of the most common complaints I hear in my office. Women are not only bothered by discharge, but almost always think it's an STD. So I want to give an overview of the most common ways that STDs present - to maybe save you some stress while you're waiting to get to your gyno's office for testing.

Signs that are common among STDs:

• Grey or green discharge. Trichomonas infection - a common but not well-known STD - often causes this kind of discharge, which may be frothy as well.

• Red bumps. Herpes can look like genital acne--but much more painful. When looked at closely, the bumps are actually clear, with a red "base" that shines through.

• Flesh-colored bumps. Genital warts (aka condyloma or low-risk HPV) look something like skin tags when alone, but may cluster together (like a small cauliflower). Like herpes, they can be on your labia, in your groin, at the entrance to your vagina, or near your anus.

• Skin ulcers. Severe herpes outbreaks (especially a first, or primary, outbreak) can progress from bumps to ulcers--craters or fissures in the skin that are extraordinarily painful. And a primary syphilis infection generally presents with a single, painless ulcer.
  

• Dark urine, yellow skin and muscle pain. Hepatitis infections are often sexually transmitted (hep B and C), but their symptoms come from the effects of the virus on the liver.
  

Symptoms that are most often NOT STDs:

• Vulvar itching. The hallmark of a yeast infection. Rarely can signify a mild herpes infection (but even more rarely if there's no bumps within a few days).
  

• White discharge. Possibly bacterial vaginosis (BV), but may be normal discharge as well. If it's clumpy and cottage cheesy, it may be yeast.
  

• Clear discharge. Most often is normal discharge (and often indicates impending ovulation).
  

• Fishy odor. Classic BV.
  

Symptoms that may or may not be an STD:

• Painful urination. While most often a garden-variety UTI, this may be the first sign of chlamydia or gonorrhea.

• Painful intercourse. There are many causes of pain during sex, but one of them may be an STD.

• Flu-like symptoms. Fever, headache, swollen lymph nodes and fatigue are most often influenza or a cold - but this is also how HIV infection presents for many people.
  

The scariest symptom of all:

• Feeling normal. Unfortunately, many STD infections don't have any symptoms at all. All the more reason to make sure you're getting tested (for HIV and other STDs) at least once a year or after a new partner.