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Can You Have an STI without Symptoms?

By Adrienne Ton, NP

TL; DR: Yes, you can absolutely have an STI/STD without symptoms. That’s why regular screening and safe sex measures like condoms are important to maintain your sexual and reproductive health.

When we offer patient’s screening for sexually transmitted infections, people will often say something along the lines of “No, I don’t have any symptoms, I don’t think I need it” or “I’m usually pretty safe so I think it’s fine”.

STIs are more common than many people think. According to the World Health Organization, over 1 million STIs are found every day around the world and the majority of those people do not have symptoms (1). This does not mean that you should stop having sex. It just means that you should try to know your status and your partner(s), because STI's are not always as obvious as you might think.

Reasons why you should get screened for STIs, even if you don’t have symptoms:

You’re having sex. If you’re having sex, you’re at risk for STIs. While safer sex practices like using condoms 100% of the time are excellent in reducing your risk, it’s still possible to get an STI. Condoms can’t cover every part of the genitals or mouth or anus - you might get exposed to infections like herpes (HSV) or warts which might appear on areas that are not always covered by a condom.
STIs don’t always start with the classic symptoms you might expect. People also commonly think about symptoms like rashes or trouble urinating or abnormal discharge with STIs. However, STIs can present in different ways. For example, syphilis is known as “The Great Pretender” because its symptoms can be mistaken for different illnesses. Sometimes it’s a rash on a different part of the body, such as a rash that occurs on the palms of the hands and soles of the feet with syphilis.

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Some people never develop symptoms or they get such mild symptoms that they don’t notice they had an infection. According to the CDC, most women with gonorrhea don’t have any symptoms - and if they do, those symptoms might get mistaken for a urinary tract infection or other vaginal infection (2). Sometimes people have very mild symptoms that they don’t think about until later. For example, some people might have forgotten about the little rash at their vulva a few years ago that could have been a herpes infection, but they never got it checked since it went away. Another example is HIV - in the early stages of HIV, people may experience flu-like symptoms, like fever, sore throat, and fatigue. These symptoms may get mistaken for a flu that then resolves and not get discovered until later.
Some people’s anatomy or body type can make it harder to know if they have an infection. For example, people with vaginas might not be able to see some signs of sexually transmitted infections if they’re inside the vagina. For example, the first sign of syphilis is a “chancre”, a small sore located at the area where syphilis entered the body. The chancre is often painless - so if you can’t see it and you can’t feel it, you may not ever notice it’s there.
Some infections can have periods of latency, meaning periods where you show symptoms and periods where you don’t show symptoms. Syphilis is a good example of this. The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years. After a while however, it can cause problems like neurosyphilis if the infection spreads to your nervous system.
You can spread STIs, even if you don’t have symptoms. The reason why STI rates are increasing is not just because people with symptoms are intentionally spreading it to others. For example, you can still spread herpes even if you're not having an outbreak (although it is less likely).

Finding an STI early on can help prevent problems before they arise. Regular STI screening is testing for infections before you have symptoms. Screening helps to catch an infection early and treat it before it causes issues later on.

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There are a lot of ways that STIs can hide, but there are also a lot of ways that you can help protect yourself and your health. Safe sex practices like condoms and regular STI screenings are some of the most powerful tools we have to help prevent STIs.

This article provides information about sexual health, healthcare and/or related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of TBD HEALTH INC.

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