Sexually transmitted infections (STIs) can cause symptoms including changes to urination and discharge, itching, painful sex, bleeding, sores, rashes, and pregnancy complications in females.

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STIs are infections that develop when bacteria, viruses, or parasites pass between people during sexual contact. Some have a cure that removes the infectious organism from the body, while others remain in the body and may require long-term management.

People can reduce the risk of STIs through some types of contraception, reducing sexual contact, or vaccinations. The infections can cause different symptoms in males and females, and factors such as pregnancy can also increase the risk of complications in females who acquire an STI.

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STIs may never cause symptoms. However, according to the American Urological Association, STIs generally cause the following symptoms in females when they occur:

Symptoms that may affect both sexes include:

The Office on Women’s Health advises that some STIs can lead to more serious health problems for females than males. For example, chlamydia and gonorrhea can lead to ectopic pregnancy without treatment, which can be life threatening. Syphilis can contribute to infant mortality for pregnant females in 4 in 10 women with the STI.

Females also have a higher risk of acquiring an STI than males during sex without a condom or another barrier method as vaginal tissue is thinner and more delicate, making it easier for pathogens to penetrate.

Several common STIs have specific effects in females, including:

  • Chlamydia: This is the most common STI that occurs due to bacteria in the United States. Females with chlamydia may experience vaginal bleeding between periods, discharge, and lower abdominal pain. Treatment is necessary to remove the STI and decrease the risk of serious female reproductive system damage and preserve fertility.
  • HPV: Most people will have a type of HPV at some point in their lives. High risk HPVs can cause several types of cancer. Two of these, HPV-16 and HPV-18, are responsible for most HPV-related cancers, which can include cervical, vaginal, and vulvar cancer.
  • Gonorrhea: This STI is most common in people ages 15 to 24 years. In females, it can cause vaginal discharge and lead to fertility problems or complete infertility. Treatment can completely get rid of the bacteria that causes gonorrhea.
  • Genital herpes: The Office on Women’s Health reports that 1 in 5 females ages 14 to 49 years has genital herpes, many without knowing. The symptoms of herpes in females are similar to those in males. The herpes simplex virus type 2 (HSV-2) commonly transfers through contact with genital blisters during sex. Type 1 (HSV-1) can transfer through oral sex and cause oral herpes. Type 1 can also rarely cause genital herpes.
  • Trichomoniasis: This is a parasitic infection that is more common in females than in males. Older females are also more likely than younger females to have the infection. Females may notice foul-smelling discharge and experience painful sex. Treatment with antibiotics can prevent the STI from lasting a long time and reduce the risk of low birth weight in future pregnancies.

According to the American College of Obstetrics and Gynecology, people can reduce the risk of STI transmission in the following ways:

  • limiting the number of sexual partners, as the risk increases with the number of sexual partners
  • using condoms consisting of latex or polyurethane during every sexual encounter involving vaginal, anal, or oral sex
  • developing an awareness of which sexual practices increase transmission risk, such as anal sex (which can lead to tissue breakage and transmission in the rectum) and practices involving bodily fluids
  • receiving vaccines for HPV and hepatitis B

During pregnancy, STIs can lead to premature labor, increase the risk of infant mortality, and lead to infections in the womb after birth.

Some STIs, including syphilis, can transfer between the birthing individual and their baby through the placenta. Others, including gonorrhea, chlamydia, herpes, and hepatitis, might pass on in the birth canal. HIV can transfer at any time during pregnancy or delivery.

If an infant acquires an STI during pregnancy, their risk of serious complications increases, including:

  • a birth weight under 5 pounds
  • infections in the eyes, lungs, or blood
  • brain damage
  • coordination issues
  • deafness
  • blindness
  • liver inflammation and chronic liver disease with scarring
  • meningitis
  • mortality

People can take antibiotics to treat chlamydia, syphilis, trichomoniasis, and gonorrhea. Females can use certain antibiotics during pregnancy safely. Most STI treatments are also safe to continue during breastfeeding, but some caution is necessary.

Females with HPV, gonorrhea, or chlamydia can breastfeed. Those with trichomoniasis can take metronidazole, an antibiotic, to cure the STI during breastfeeding but may need to wait 12 to 24 hours before breastfeeding after taking it. Individuals with herpes or syphilis can breastfeed if the infant or pump does not come into contact with sores.

It is not advisable for people living with HIV to breastfeed.

Some STIs may transfer to females during sexual assault.

The Centers for Disease Control and Prevention (CDC) advises that the most common STIs that doctors diagnose after sexual assault include trichomoniasis, gonorrhea, and chlamydia, although they are common and do not necessarily transfer during the assault.

Medical professionals recommend attending an examination as soon as possible to test for STIs and receive vaccinations.

Doctors may administer the following treatments after an assault to reduce the risk of several STIs:

  • antibiotics, including ceftriaxone, doxycycline, or metronidazole
  • post-exposure hepatitis B vaccination for those with unknown vaccination status or a booster dose for those with a previous vaccination
  • HPV vaccination
  • HIV post-exposure prophylaxis (PEP), depending on the circumstances and an individual’s health status

Certain measures can prevent an STI from passing to other sexual partners and allow individuals with a positive diagnosis to start treatment.

The United Kingdom’s National Health Service (NHS) recommends the following measures to support this:

  • taking steps to inform previous and current partners so they can receive treatment
  • starting treatment and encouraging previous and current partners to do the same
  • avoiding all forms of sexual contact until finishing treatment

Many STIs are curable, and treatments can be effective in significantly reducing the impact of others on daily life.

Common sexually transmitted infection (STI) symptoms in females include burning or more frequent urination, foul-smelling discharge, pain during sex, itching, abnormal vaginal bleeding, sores, and rashes. The exact symptoms depend on the STI. Some common STIs include gonorrhea, HPV, chlamydia, syphilis, and trichomoniasis.

STIs can also affect female fertility, pregnancy, and breastfeeding, which can pose a significant risk for embryos and newborns. Treatment can reduce the risk of transmission between the birthing individual and their child. Transmission can also occur during sexual assault, so prompt diagnosis, vaccines, and management afterward are essential for reducing the effects of any STIs.

It is important that people discuss any positive diagnoses with previous or current partners. Having these discussions is essential in helping ensure that all potentially involved individuals receive treatment as soon as possible and abstain from sexual activity until afterward.