There seems to be an awful lot of unprotected sex going on – guess what? That increases the risk of STIs! Recurring lapses in judgment. That little voice that says “wear a condom” was silenced by what? Alcohol (the usual suspect). The heat of the moment. Sometimes just embarrassment. As gynecologists, we get it and we’ve heard it before.
A recent patient: Using withdrawal as her form of birth control and comes to my office desperate for STI screening. Both situations could be remedied by using condoms. I tell her, first and foremost: USE A CONDOM (in this voice, too). IT’S IMPORTANT. I care about you and want you to be safe.
Here were some basic STI issues we addressed:
What’s the difference between sexually transmitted infections (STIs) and sexually transmitted diseases (STDs)?
They are the same thing. The terms are used interchangeably, but everyone is slowly transitioning to STIs. Disease implies a symptomatic and easily identifiable medical disorder, but the majority of STI are asymptomatic. And all STIs are infectious (they are transmitted through contact), so using the term “infections” instead of “disease” is more accurate.
What STIs should I be screened for?
It depends on your age and medical conditions and sexual encounters. The most common STIs we screen / test for are Chlamydia, Gonorrhea, Trichomonas, Hepatitis B and Hepatitis C, HIV, Syphilis, Herpes, and HPV.
How long should I wait after unprotected sex to get tested?
Most STIs take a couple weeks to show up positive on a screening test. A good, general rule of thumb is to wait 2 weeks after an exposure to be tested for the most common infections – Chlamydia, Gonorrhea, and Trichomonas. For the other STIs (syphilis, Hepatitis B, Hepatitis C, HIV), waiting closer to 4-6 weeks can optimize results. HPV is screened through pap smears, and a health care professional can advise how frequently to do it for you. Herpes isn’t usually tested by blood work. Keep an eye out for painful lesions in the genital region and get them checked out when they’re there – this is the most accurate way to diagnose herpes.
The goal, of course, is to catch an infection early.
How am I tested for STIs?
Urine and/or blood tests. Many patients who go to a gynecologist get an exam first, to check for obvious lesions (like herpes outbreaks) or pelvic inflammatory disease. But an exam isn’t necessary, so don’t let that deter you.
What do I do if it’s positive?
Many of these infections (the bacterial or parasite ones) go away with antibiotics – Chlamydia, Gonorrhea, Trichomonas, Syphilis. That doesn’t mean the long terms consequences go away – Chlamydia is associated with chronic pelvic pain and fertility problems. It seems the sooner it’s diagnosed and treated, the less severe the consequences.
The viral infections – Herpes, HPV, Hepatitis, HIV – never really go away. There are meds to alleviate your symptoms or stop the virus from replicating uncontrollably. If you’re positive for one STI, you should be screened for all of them.
When can I have sex again?
If everything comes back negative, whenever you want (BUT USE A CONDOM!). If you need to take antibiotics, it’s safe to have sex 7 days after you finish the antibiotics.
I am a board certified OBGYN at Cedars Sinai in Los Angeles.
I am co-founder of Female Health Education, a platform offering digital courses, striving to empower females through health education.
My passion is promoting and demystifying health information to the public. My blog, Dr. Sara Twogood’s LadyParts Blog, provides comprehensive information about fertility, pregnancy, and gynecology topics. I am on the medical board for the period tracker app Flo; contribute as a medical expert for pregnancy app and website The Bump; and serve on the Byrdie Beauty and Wellness Review Board (Byrdie.com). I have been featured as an expert for the podcasts The Dream and Her body, Her Story and quoted in numerous online and print publications.
I am honored to be named “Top Doctor” in Los Angeles magazine for years.