Tuesday, March 24, 2009

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.


L said...

A friend of mine without symptom recently spread Molluskum Contagiosum to a lover (who has Chron's and as such is immunocompromised) and did the right thing waiting for son in the waiting room as his GP froze the little mars off, including one right on his penis. Live and learn.

ragon63366 said...

Posted by Lori 12 minutes ago

I think i might have(BV) Bacterial Vaginois I have the white discharge and the fishy odor. I thought it was a yeast infection and took diflucane with no help fishy smell is still there. I am not sexually active this may be the reason why. I have no insurance and unemployed i,ve had this probably for at least 8 months. How can i get rid of it and can it be harmful the longer i have it? Where or How did i get it?

Dr. Kate said...

Lori, BV is not sexually transmitted - it's overgrowth of one of the natural bacteria in your vagina. We're not sure why BV happens - but it happens all the time in healthy women, sexually active or not. Unfortunately, there's no over-the-counter remedy for it. Try your local Planned Parenthood - they can do a exam for you on a sliding scale (charging you according to your income, or lack thereof), which will be more affordable.