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When to Call for STI Exposure - Female

Care Advice

STI Prevention

1. Abstinence and Other "Safe" Sexual Activities:
   • Abstaining from sex (vaginal, oral or anal) is the only 100% effective means of not getting STIs.
   • Actions which are believed safe (and don't often spread STIs) are holding hands, hugging, touching and kissing (as long as there are no sores on the lips or in the mouth).
2. How to Prevent Sexually Transmitted Infections (STIs):
   • Most STIs are spread by exchange of body fluids (semen, vaginal fluids or blood) during oral, anal or vaginal sex.
   • They can also result from direct contact with any sores during sex.
   • Condoms are the only trusted way to prevent most STIs during sex.
3. Use of Condoms:
   • Condoms are the only trusted way to prevent most STIs during sex.
   • Putting on a condom: (1) Hold the condom at the tip to squeeze out the air. (2) Roll the condom all the way down the erect penis. Don't try to put a condom on a soft penis.
   • Taking off a condom: (1) After sex, hold onto the condom while the penis is being pulled out. This will keep the condom from coming off before the penis is out. (2) The penis should be pulled out while still erect, so that sperm (semen) doesn't leak out of the condom.
   • Buy latex rubber or plastic condoms. Never use condoms made from animal skins; they can leak.
   • If you use a lubricant during sex, make sure it is water-based (like K-Y Liquid). Do not use petroleum jelly, vegetable oil or baby oil. These can cause a condom to break.
   • For more facts about condoms, see website Condom Effectiveness.
4. Actions that Don't Prevent STIs:
   • Douching (rinsing out the vagina with water or other fluids) or showering after sex does not prevent STIs.
   • Withdrawal (when a man pulls his penis out before he ejaculates or 'comes') is not a way to prevent STIs or pregnancy.
   • Having an STI once does not prevent you from getting it, or a different type, again.
   • Using other forms of birth control, such as the IUD, birth control pill, implant or shot, doesn't prevent you from getting an STI.
   • You still need to protect yourself with condoms.
5. Call Your Doctor If:
   • You have any symptoms that you think might be an STI
   • You have sex without a condom or the condom breaks during sex. Reason: emergency contraception pills can prevent pregnancy if taken within 72 hours.
   • You miss your period and might be pregnant
   • You have other questions or concerns

STI Facts

1. AIDS (HIV)
   • Cause: HIV (Human Immunodeficiency Virus) Human Immunodeficiency Virus (HIV), is a virus which destroys some of the white cells in the blood which help us fight off infection. They then become unable to do so and the immune system becomes weak. AIDS stands for Acquired Immunodeficiency Syndrome. This term covers the range of infections and illnesses which can result from a weakened immune system caused by HIV.
   • Symptoms: flu-like symptoms start in 2-6 weeks. They are fever, sore throat, swollen lymph nodes, rash and muscle pains. These symptoms last 1 to 2 weeks. After many years of silence, the virus attacks a person's immune system (AIDS). That causes fevers, rapid weight loss, long-term diarrhea, pneumonia and many other severe infections.
   • How it is spread: by any sexual acts that involve the exchange of body fluids, such as vaginal fluids, semen or blood. Also spread by injecting drugs with dirty (used) needles or syringes, or an accidental needlestick injury from a contaminated needle. Can be spread from a mother to her baby during pregnancy or giving birth, or during nursing.
   • These do NOT spread HIV: saliva, tears, sweat or urine. It is rare that a human bite would spread HIV. Donating blood does not spread HIV. All donated blood in the U.S. is screened for HIV so that getting a blood transfusion is believed to be safe.
   • Incubation Period: in 6-12 weeks after exposure, the HIV antibody test becomes positive. HIV often does not cause any symptoms of AIDS for many years (1-10 years).
   • HIV Exposure: risk must be checked right away. If you are at high risk for HIV and were exposed less than 72 hours ago, medicine may be helpful.
   • Testing: a blood test is often performed 3 months after exposure if there are no symptoms. This test may be done anonymously (without giving your name) or confidentially, through your doctor. Find anonymous testing sites by calling the CDC AIDS Hotline at 1-800-342-AIDS. Whether done anonymously or confidentially, it is important that you share the information with a trusted doctor.
   • Treatment: there is no current cure for HIV/AIDS. There are many drugs that can control HIV and prevent future problems. Most people with HIV can be kept feeling healthy for many years. All sex partners should be tested.
2. Chlamydia
   • Cause: Chlamydia bacterium.
   • Symptoms:
     • In women, Chlamydia is mostly an infection of the cervix or the womb. If a woman has symptoms, she will have a vaginal discharge (often yellow or green). There may also be pain in the pelvic area when having sex or vaginal bleeding after having sex.
     • In men, Chlamydia causes swelling of the urethra (the duct or tube that pee or semen travel through). Men with symptoms will have discharge from penis and/or problems peeing.
     • It often causes no symptoms in men or women, so you may not know you have an infection.
     • Chlamydia can cause infections in eyes, lungs or throat.
   • How it is spread: by sex (vaginal or anal).
   • Incubation Period: varies from days to weeks.
   • Testing: it is diagnosed by a urine test or a swab taken from the urethra or vagina.
   • Treatment: antibiotics. Re-infection is common. Sex partners for the past 6 months should be tested and treated, if necessary. If not treated, it can result in re-infection. And for women, there may be future problems, such as pelvic inflammatory disease, ectopic pregnancy, or infertility. If you are pregnant when you have the infection, you will be retested after completing treatment.
   • Prevention of Spread: do not have sex until treatment is done and all symptoms are gone. Use a condom to prevent re-infection or risk of spreading to others.
   • See your doctor if symptoms do not clear with treatment. Make sure you take all the antibiotics as advised.
3. Gonorrhea
   • Cause: Neisseria gonorrheae bacteria.
   • Symptoms:
     • In women, it often causes an infection of the cervix. Symptoms for women may be vague: more vaginal discharge than normal, abnormal period, bleeding between periods, pain with sex or pain with passing urine. Many women have no symptoms. If infection spreads to the womb it can cause infertility.
     • In men, it causes infection of the urethra. Symptoms in men are penis discharge and/or pain or trouble with passing urine. If infection spreads to the prostate or the tubes around the testicles, it can cause infertility. Most men will have symptoms.
     • In both men and women, can also be an infection of the eyes and/or throat (from oral sex) or of the rectum (from anal sex). Throat infections may cause a sore throat with pus on the tonsils or no symptoms at all.
     • Infection in pregnancy can lead to an ectopic pregnancy, miscarriage or premature birth. The infection can be passed to the baby during delivery and causes an infection of the baby’s eyes
   • How it is spread: by vaginal, anal or oral sex.
   • Incubation Period: often 2-7 days.
   • Testing: diagnosed by a urine test or a swab taken from the urethra, vagina, rectum or throat.
   • Treatment: antibiotics. Sex partners should be treated. If not treated, can result in future problems, such as pelvic inflammatory disease and possible infertility, ectopic pregnancy in women. In men, it can result in epididymitis (inflamed tube behind the testicles).
   • Prevention of Spread: do not have sex until treatment is done and all symptoms are gone. Use a condom to prevent re-infection or risk of spreading to others.
   • See your doctor if symptoms do not clear with treatment. Make sure you take all the antibiotics as advised.
4. Hepatitis B (HBV)
   • Cause: Hepatitis B Virus (HBV). Hepatitis means swelling of the liver.
   • Symptoms:
     • HBV can cause a short-term infection that may not have any symptoms. After the infection, a small number of adults develop an ongoing infection. Some will remain well, but can pass the infection on to others. A few will develop serious problems with their liver (hepatitis).
     • Hepatitis caused by HBV is a serious illness. It affects people in different ways. Some people have no symptoms. Some people feel tired, have nausea, muscle aches, fevers, yellow eyes, and yellow skin. Some people are never able to fully fight off the infection. These people go on to have long-term hepatitis.
     • Sometimes people die from hepatitis B.
   • How it is spread:
     • HBV can be spread through the exchange of body fluids, such as vaginal fluids, semen or blood.
     • You can get infected through having sex (vaginal, oral or anal) with an infected person.
     • The highest amounts of HBV are found in the blood of the infected person. Anything contaminated with that blood can spread the infection. It can be spread by injecting drugs with dirty (used) needles or syringes, an accidental needlestick injury with a contaminated needle, use of non-sterile equipment in a hospital or at the dentist, or sharing things that may be contaminated, such as toothbrushes. The virus can live outside the body for more than a week.
     • A bite from an infected person or getting their blood into your eyes, mouth or on a wound can also lead to infection.
     • It can also be spread from a mother to her baby during pregnancy, giving birth, or nursing.
     • In the past, getting a transfusion of blood from an infected person was another cause. These days, all blood it tested for infection before being given as a transfusion to another person.
     • Safe Body Fluids: these body fluids do not spread HBV: saliva, tears, sweat or pee.
   • Incubation Period: 6 weeks to 6 months.
   • Testing: blood tests.
   • Treatment: there are many anti-viral drugs for treating hepatitis from HBV.
   • Prevention of Spread: there are two different meds that help prevent HBV: hepatitis B vaccine and hepatitis B immune globulin.
   • Vaccine: the Hepatitis B vaccine helps prevent getting HBV in the future. It is recommended for all newborns. It is also recommended for any teen or adult at risk for getting HBV. All health care providers should get this vaccine.
   • Immune Globulin: hepatitis B immune globulin (HBIG) is used to prevent HBV after you have been exposed to it. HBIG is not needed after an HBV exposure if you have already gotten the HBV vaccine.
5. Herpes Simplex (Genital Herpes)
   • Cause: the herpes simplex virus. This is the same virus that causes cold sores on the lips.
   • Symptoms:
     • Painful, fluid-filled blisters which often are grouped in clusters and appear over a few days. They occur any place around the vagina or on the penis. The blisters dry out, crust over and heal in 7-10 days, but can take longer. With the first event, the symptoms are worse and you may feel ill with fever and aching. There may also be swollen glands in the groin which are small and sometimes tender.
     • After the first infection, the virus lies sleeping in nerve fibers. It can return to cause another bout of infection. Some people get several bouts of infection a year, but they usually occur less often over time. The blisters are often less painful and last a shorter amount of time than for the first infection.
     • Many people who are infected with the herpes virus do not have symptoms or may have only very mild symptoms.
   • How it is spread: genital herpes is spread by sex (vaginal or anal) or by any direct contact with the genitals of a person who has an active herpes infection (first or repeat episodes). Oral herpes (fever blisters) can also be spread to the partner's genitals during oral sex.
   • Incubation Period: 2 days to 2 weeks.
   • Testing: genital herpes can be diagnosed with a swab taken from a blister.
   • Treatment: anti-viral drugs may be used for genital herpes if it is started within the first 3 days of having the blisters. These drugs don't cure the disease, but can shorten the time the symptoms last. Sex partners should be tested.
   • Prevention of Spread: do not have sex or contact with the blisters until treatment is done and all symptoms are gone. Use a condom to prevent re-infection or risk of spreading to others.
6. Lice (Genital or Pubic Lice)
   • Cause: a parasite, also known as the pubic louse or "crab louse." The lice most often infest the genital and anal areas, though other hairy parts of the body may also be involved. But, the scalp is rarely involved by the pubic louse.
   • Symptoms: itching and a rash are common symptoms.
   • How it is spread: it is most often spread by contact through sex, but may also be transferred through items such as clothing and bedding.
   • Incubation Period: symptoms of itching may occur 1-2 weeks after contact.
   • Testing: eggs (nits), nymphs and adult lice may be seen with the naked eye. Nits are small, yellowish-white, shiny, oval eggs attached to pubic hair shafts. Lice are grayish-white, oval, wingless insects 1-4 mm long.
   • Treatment: medicines which kill the lice can be found over-the-counter and by prescription. A common brand is Nix. A second treatment is suggested 7-10 days after first treatment. Bedding and clothes should be machine washed after treatment to kill all parasites. All sex partners within the last month should be treated. Re-infection is possible.
   • Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.
7. Mycoplasma genitalium (Mgen)
   • Cause: a bacterium.
   • Symptoms:
     • There may be few, and often no, symptoms. In some cases symptoms are similar Chlamydia. It may be mistaken for Chlamydia and can occur at the same time as Chlamydia infection. It affects the urethra, vagina, womb and fallopian tubes in women. It affects the urethra and sperm carrying tubes in men.
     • In women symptoms include a vaginal discharge (often yellow or green). There may also be pain in the pelvic area when having sex or vaginal bleeding after having sex.
     • In men, there may be a discharge from penis and/or problems peeing.
   • How it is spread: Mgen is spread by genital-to-genital contact. It may be passed on through oral sex (uncertain).
   • Incubation Period: varies from days to weeks.
   • Testing: is by a urine test or a swab taken from the urethra or vagina.
   • Treatment:
     • Antibiotics. It may be resistant to some antibiotics. It will not go away without treatment.
     • If not treated, it can cause problems in women, such as pelvic inflammatory disease, ectopic pregnancy, or infertility.
     • If you are pregnant when you have the infection, it is important to tell your doctor. Some of the antibiotics used to treat Mgen can be harmful to your baby. The infection can result in miscarriage or premature birth. Your baby could be infected during delivery.
   • Prevention of Spread: do not have sex until treatment is done and all symptoms, if present, are gone. Use a condom to prevent further infection or risk of spreading to others.
   • See your doctor if symptoms do not clear with treatment. Make sure you take all the antibiotics as advised.
8. Syphilis
   • Cause: Treponema pallidum bacteria.
   • Symptoms: Symptoms change depending on how long you have had the infection.
   • Syphilis first causes a chancre (syphilis sore) 2 weeks to 3 months after infection. This is a skin ulcer on the genitals, anus or mouth. It's often painless, so it may not be noticed. After 3-6 weeks, if untreated, the chancre goes away on its own, but the person is still infected. This is called Primary Syphilis.
   • Many weeks after the chancre, if untreated, a viral-like illness with a rash may occur. There may be wart-like lumps on the genitals, joint pains, swollen glands and you may feel ill. This is Secondary Syphilis.
   • Years later, if untreated, the infection may spread to the heart, nervous system, blood vessels and skin. This is Tertiary Syphilis.
   • Infection while pregnant can cause miscarriage or the baby could be still-born or premature. It can also be passed to the unborn baby, causing serious health problems. This is Congenital Syphilis.
   • How it is spread: mainly by sexual contact, such as vaginal, anal or oral sex. Also by kissing (if the syphilis sore is in or on the mouth), or by touching someone's open syphilis sore. Any person who may have been exposed should have a blood test. Reason: many infections occur with no symptoms.
   • Incubation Period: chancre (sore) grows within 10-90 days (average is 3 weeks).
   • Testing: blood tests and sometimes a sample taken from an open sore.
   • Treatment: antibiotics. Sex partners should be tested and treated. With no treatment, syphilis can lead to many future problems, such as disease of the brain and problems with pregnancy.
   • Prevention of Spread: do not have sex until treatment is done and all symptoms are gone. Use a condom to prevent re-infection or risk of spreading to others.
   • See your doctor if symptoms do not clear with treatment. Make sure you take all the antibiotics as advised.
9. Trichomonas
   • Cause: Trichomonas vaginalis protozoa.
   • Symptoms: in women, this may cause a bad-smelling, yellow, sometimes frothy vaginal discharge. May also cause vaginal itching and redness, or pain with passing urine. Many women and most men do not have symptoms.
   • How it is spread: by sex. Re-infection is common.
   • Incubation Period: can differ from 4-28 days.
   • Testing: check a sample of the vaginal discharge under the microscope. May also be found on a PAP smear.
   • Treatment: antibiotics. Sex partners should be tested and treated.
   • Prevention of Spread: do not have sex until treatment is done and all symptoms are gone. Use a condom to prevent re-infection or risk of spreading to others.
   • See your doctor if symptoms do not clear with treatment. Make sure you take all the antibiotics as advised.
10. Warts-Genital
    • Cause: Human papilloma virus (HPV). There are several different HPV viruses that cause genital warts. Some types of these viruses also cause ‘common’ warts on other parts of the body. These are different from warts spread through sex.
    • Symptoms: warts are skin-colored growths. They may be very flat and hard to notice or have a cauliflower-like surface. They can grow together and become quite large. Warts can occur any place on the genitals of men or women, and on the anus (even though you may not have had anal sex). Most warts do not have symptoms, but they can cause itching or interfere with sex if they are large.
    • How it is spread: by sex (vaginal, oral or anal).
    • Incubation Period: varies from 3 months to 2 years.
    • Testing: most often by visual exam. In women, warts that grow inside the vagina or on the cervix need a pelvic exam for diagnosis.
    • Treatment: varies. Applying meds in the doctor's office or 'freezing' with liquid nitrogen are the most common. It often needs many more treatments over time. Over-the-counter wart meds for 'common' warts do not work. Do not try to treat yourself with these medicines. All sex partners should be checked. Reason: re-infection by untreated partners is common.
    • Prevention of Spread: the Human Papilloma Virus vaccine (HPV) can prevent most genital warts and cervical cancer. Between 15 and 24 years of age, 25% of sexually active teens become infected with HPV. Young girls should be vaccinated before they become sexually active, if possible. The target age is 11-12 years. The vaccine is also urged for boys at the same age. Because of the risk of cervical cancer, women who have had genital warts should have regular cervical smear tests done.

Other Infections Sometimes Thought of as STIs

1. Bacterial Vaginosis (Gardnerella) This is not an STI.
   • Cause: a common vaginal infection in post-puberty young women. It is caused by an overgrowth of certain bacteria in the vagina.
   • Symptoms: may cause a thin, white vaginal discharge with bad (fishy) odor. Often doesn't cause itching or pain. May also have no symptoms.
   • How it is spread: this is not clear, but it does not have to be spread through sex. Can also occur in non-sexually active teens.
   • Incubation Period: unknown.
   • Testing: a sample of vaginal discharge is looked at under a microscope.
   • Treatment: oral medicine that needs a prescription. Sometimes vaginal cream is prescribed.
   • Prevention of Spread: this is not an STI. Men do not get this infection. Treatment of male sex partners is not needed.
2. Molluscum Contagiosum
   • This is not an STI, but may be spread from close skin-to-skin contact during sex.
   • Cause: a virus.
   • Symptoms: flesh-colored round bumps on skin, sometimes with a dimple in the center. Often cause no other symptoms.
   • How it is spread: by direct contact with molluscum any place on the body. May or may not be spread through sex. May also be spread by sharing towels or sheets with an infected person.
   • Incubation Period: a few weeks to a few months.
   • Testing: most often by visual appearance. Sometimes fluid is squeezed from one of the bumps and sent to the lab.
   • Treatment: medicines put on the bumps or 'freezing' with liquid nitrogen. Sex partners should be checked and treated if molluscum are seen. The infection is usually harmless and will go away on its own after 12-18 months.
   • Prevention of Spread: use a condom to reduce the risk of spread during sex or do not have sex until treatment is done and all symptoms are gone.
3. Scabies. This is not an STI.
   • Cause: a mite (tiny insect) called Sarcoptes scabiei. It can burrow into your skin, often through your hands, and then spread around your body.
   • Symptoms: itching often starts on the hands but spreads to other parts of the body. There may be tiny dark lines (burrows) between the fingers or on the wrists and hands. An itchy rash may develop.
   • How it is spread: close skin to skin contact such as hand-holding with an infected person or during sex.
   • Incubation Period: infection occurs at the time the mites pass from one person to another. The rash can take from 2-6 weeks to develop.
   • Testing: not usually needed.
   • Treatment: lotions or creams you can buy over-the-counter at a pharmacy, without a prescription.
   • Prevention of Spread:
   • It is important that all family members and close contacts are treated at the same time, even if they do not have symptoms. Reason: symptoms can take up to 6 weeks to develop.
   • Bedding, clothing and towels should be hot washed to clear them of mites. Mites can live for up to 36 hours away from the body.
4. Yeast Infection (Vaginal Yeast) This is not an STI.
   • Cause: a yeast, Candida albicans.
   • Symptoms: in women, vaginal discharge (often thick and white), vaginal-area itching, redness, or pain. Also pain with passing urine can happen. Men may have itching, discharge and redness around the head of the penis.
   • How it is spread: Candida is found everywhere on the body. It normally lives on the skin, in the mouth, in the vagina, and in the intestines of healthy people without causing infection or symptoms. Overgrowth of yeast can occur with diabetes, taking antibiotics and for unknown reasons. It is when there is overgrowth that you may notice symptoms.
   • Incubation Period: unknown.
   • Testing: can often be diagnosed by appearance alone. A swab taken from the vagina (or the head of the penis) is looked at under the microscope or cultured.
   • Treatment: anti-yeast medicines. Some meds, such as Clotrimazole and Miconozole, can be purchased over-the-counter. These may be in cream or tablet form.
   • Prevention of Spread: This is not a STI. Women are more often affected than men, but men may become infected. Treatment of male sex partners is not needed unless they have symptoms.

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

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