Aa
STD concern
Hello,
I am a 25 year old female. I basically haven't been sexually active for two and a half years now, but a topic of discussion came up about getting checked for STDS. I have been checked for chlamyodia and HIV and both were negative. Since being sexually active I have never had any symptoms (itching, burning, chancers, rashes, discharge, pains, etc.) Being tested for all STDS was never a concern because I never had symptoms.
Since it's been a few years since my last sexual activity, should it be a concern to get tested? Does a symptom of some sort usually come up if not at first, a few months later? If I do have an STD, is it too late to treat it or could it have caused more serious problems by now?
I am going to get the other STDS tested, but I have been just a little worried, and wanted some advice in the mean time. Thanks!
I am a 25 year old female. I basically haven't been sexually active for two and a half years now, but a topic of discussion came up about getting checked for STDS. I have been checked for chlamyodia and HIV and both were negative. Since being sexually active I have never had any symptoms (itching, burning, chancers, rashes, discharge, pains, etc.) Being tested for all STDS was never a concern because I never had symptoms.
Since it's been a few years since my last sexual activity, should it be a concern to get tested? Does a symptom of some sort usually come up if not at first, a few months later? If I do have an STD, is it too late to treat it or could it have caused more serious problems by now?
I am going to get the other STDS tested, but I have been just a little worried, and wanted some advice in the mean time. Thanks!
MEDICAL PROFESSIONAL
Gonorrhea clears up long before 2 years, even without treatment. Syphilis is too rare to worry about. I've told you the pros and cons of herpes testing; I can't give you specific advice about it. This forum doesn't give specific medical advice, so you're on your own -- or discuss it with your primary care provider.
Thanks very much for your response! Just to clarify, should I still get tested for syphilis, gonorrhea or herpes (the three I haven't been tested for, yet) even though it's been over two and half years since my last sexual activity and have yet to have any symptoms of any STD?
MEDICAL PROFESSIONAL
Welcome to the STD forum.
I interpret your question as having two parts: Which STDs should be included in routine screening tests among sexually active people, especially women, and how often testing should be done.
The main STDs that are generally included in routine screening are chlamydia, gonorrhea, syphilis, and HIV.
Chlamydia is the biggie, by far the most common potentially serious, easily treatable STD. Gonorrhea is much less common and very low risk except in particular circumstances and population groups, but it's dangerous and testing is cheap and easy, and nowadays usually is done more or less automically when labs test for chlamydia. So it's almost always in the package.
Syphilis and HIV are still more uncommon, indeed remain very rare in most population groups. But both infections are potentially very serious (of course HIV can be deadly) and testing is highly accurate, easy, and inexpensive. So they also are in the routine screening group.
Other STDs are common yet are not tested for routinely. Human papillomavirus (HPV)? It is extremely common -- in fact so frequent that everybody gets it at one time or another and 25-35% of sexually active women have it at any one time. And generally there is no treatment and no special advice that need be given, unless symptoms (warts) or an abnormal pap smear are present at the same time. So despite its frequency, HPV testing is generally limited to an ancillary test that accompanies pap smears. The pap, to detect pre-cancerous cervical lesions, is the important test. (This might change in the future, and HPV testing per se may become an important strategy, perhaps especially in developing countries where pap testing is too cumbersome and expensive.)
What about herpes simplex virus (HSV), the cause of genital herpes? This is where there is the greatest controversy. But most experts agree that testing for HSV should be limited to people with particular risks, such as symptoms that suggest they already are infected or sex with partners known to have genital herpes. The problem is that many people without symptoms are positive for HSV-2, and the tests aren't perfect -- so often it is hard to know what advice to give to people with positive tests. Still, people who are concerned about herpes and desire testing should have it available -- but they need to understand that sometimes the results are more confusing than helpful.
Finally, when women have periodic reproductive health examinations, the provider usually does simple tests to check for vaginal infections, especially trichomonas (sexually transmitted), bacterial vaginosis (sexually associated, but not clearly an STD), and yeast infections (definitely not an STD). However, many experts believe that even these tests aren't necessary unless a woman is having symptoms like abnormal dischrage, odor, genital itching, etc.
Finally, as to frequency: Most people would agree that women do not need testing if they have not been sexually active since their last negative tests. The tests themselves (for gonorrhea, chlamydia, syphilis and HIV) are highly reliable and these infections cannot appear out of the blue in non-sexually-active people. So on that basis, I don't see that you need another round of testing at this time. However, younger younger women (under 25 or 30, depending on other factors) who continue to be sexually active should be tested periodically --- from as often as every 4-6 months if at especially high risk (e.g., particularly frequent new partnerships) to every couple of years for others. One year is a pretty good interval for most sexually active young women. However, all all women, regardless of recent sexual activity, should have regular pap smears. (I almost said annual pap smears, but there is a trend to recommending paps more like every 3 years.)
Thanks for this question, which is an important one of potential interest to many forum users. I'm going to save it in my favorites file to refer other questioners to if and when the question arises again.
Best wishes-- HHH, MD
I interpret your question as having two parts: Which STDs should be included in routine screening tests among sexually active people, especially women, and how often testing should be done.
The main STDs that are generally included in routine screening are chlamydia, gonorrhea, syphilis, and HIV.
Chlamydia is the biggie, by far the most common potentially serious, easily treatable STD. Gonorrhea is much less common and very low risk except in particular circumstances and population groups, but it's dangerous and testing is cheap and easy, and nowadays usually is done more or less automically when labs test for chlamydia. So it's almost always in the package.
Syphilis and HIV are still more uncommon, indeed remain very rare in most population groups. But both infections are potentially very serious (of course HIV can be deadly) and testing is highly accurate, easy, and inexpensive. So they also are in the routine screening group.
Other STDs are common yet are not tested for routinely. Human papillomavirus (HPV)? It is extremely common -- in fact so frequent that everybody gets it at one time or another and 25-35% of sexually active women have it at any one time. And generally there is no treatment and no special advice that need be given, unless symptoms (warts) or an abnormal pap smear are present at the same time. So despite its frequency, HPV testing is generally limited to an ancillary test that accompanies pap smears. The pap, to detect pre-cancerous cervical lesions, is the important test. (This might change in the future, and HPV testing per se may become an important strategy, perhaps especially in developing countries where pap testing is too cumbersome and expensive.)
What about herpes simplex virus (HSV), the cause of genital herpes? This is where there is the greatest controversy. But most experts agree that testing for HSV should be limited to people with particular risks, such as symptoms that suggest they already are infected or sex with partners known to have genital herpes. The problem is that many people without symptoms are positive for HSV-2, and the tests aren't perfect -- so often it is hard to know what advice to give to people with positive tests. Still, people who are concerned about herpes and desire testing should have it available -- but they need to understand that sometimes the results are more confusing than helpful.
Finally, when women have periodic reproductive health examinations, the provider usually does simple tests to check for vaginal infections, especially trichomonas (sexually transmitted), bacterial vaginosis (sexually associated, but not clearly an STD), and yeast infections (definitely not an STD). However, many experts believe that even these tests aren't necessary unless a woman is having symptoms like abnormal dischrage, odor, genital itching, etc.
Finally, as to frequency: Most people would agree that women do not need testing if they have not been sexually active since their last negative tests. The tests themselves (for gonorrhea, chlamydia, syphilis and HIV) are highly reliable and these infections cannot appear out of the blue in non-sexually-active people. So on that basis, I don't see that you need another round of testing at this time. However, younger younger women (under 25 or 30, depending on other factors) who continue to be sexually active should be tested periodically --- from as often as every 4-6 months if at especially high risk (e.g., particularly frequent new partnerships) to every couple of years for others. One year is a pretty good interval for most sexually active young women. However, all all women, regardless of recent sexual activity, should have regular pap smears. (I almost said annual pap smears, but there is a trend to recommending paps more like every 3 years.)
Thanks for this question, which is an important one of potential interest to many forum users. I'm going to save it in my favorites file to refer other questioners to if and when the question arises again.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
