The majority of sexually transmitted infections in women produce no symptoms, or symptoms so mild that they are not recognized as infection-related. Chlamydia — the most commonly reported STI in the United States — is asymptomatic in approximately 70 to 90 percent of women who have it. Gonorrhea is frequently asymptomatic or produces only mild discharge. HPV — present in the majority of sexually active women at some point in their lives — is detected through cervical cancer screening rather than by symptoms. Trichomoniasis, herpes, and syphilis have characteristic symptoms in some presentations but are often missed without specific testing.
The consequence of untreated asymptomatic STIs ranges from the serious (chlamydial and gonorrheal infections ascending to cause pelvic inflammatory disease and tubal factor infertility) to the critical (untreated syphilis) to the oncologic (HPV and cervical, vulvar, and oropharyngeal cancer). Routine screening at appropriate intervals is the mechanism by which STIs that are not producing symptoms are identified and treated before these consequences develop.
The following reflects current guidelines for STI screening in women. Individual recommendations are adjusted based on age, sexual activity, risk factors, and clinical history at the evaluation at Lapeer Women’s Health.
Chlamydia and Gonorrhea
Annual screening for chlamydia and gonorrhea is recommended for all sexually active women under age 25. Annual screening is also recommended for women 25 and older who have new or multiple sexual partners or other risk factors. Testing uses a nucleic acid amplification test (NAAT) from a vaginal swab or urine sample and is highly sensitive. Positive tests are treated with specific antibiotics and partner notification and treatment are recommended. Untreated chlamydial or gonorrheal infection can ascend to cause pelvic inflammatory disease with potential for tubal damage and infertility.
HPV and Cervical Cancer Screening
Human papillomavirus (HPV) is the most common sexually transmitted infection and is the primary cause of cervical cancer. HPV testing and cervical cytology (Pap test) are integrated into cervical cancer screening at intervals determined by age and prior results. Most HPV infections clear spontaneously, but persistent high-risk HPV strains require monitoring and in some cases intervention through the cervical cancer screening program. Learn about cervical health →
HIV
One-time HIV screening is recommended for all adults aged 15 to 65 as part of routine healthcare. Annual HIV testing is recommended for women with ongoing risk factors including multiple sexual partners, inconsistent condom use, or a partner with HIV or unknown status. HIV is a manageable chronic condition when identified, and antiretroviral therapy begun before advanced disease prevents progression and eliminates transmission risk. Testing is confidential and available at Lapeer Women’s Health as part of comprehensive STI screening.
Syphilis
Syphilis screening is recommended for sexually active women at increased risk and for all pregnant women. Syphilis is experiencing significant increases in incidence in many regions of the United States and is fully treatable with penicillin when identified. Untreated syphilis produces serious systemic consequences and, in pregnancy, can cause stillbirth or congenital syphilis in the newborn.
Herpes
Herpes simplex virus (HSV) is extremely common — HSV-2, the typical genital herpes type, affects approximately 12 percent of the adult population, and most people with HSV-2 do not know they have it. Routine serologic HSV testing is not universally recommended for asymptomatic individuals by most guidelines because of the high prevalence and the psychological impact of positive results in the absence of symptoms. Testing is appropriate when a patient has symptoms consistent with herpes or requests testing for personal knowledge. Women with recurrent genital ulcers or characteristic symptoms should be tested.
Trichomoniasis
Trichomoniasis is the most common curable STI and is significantly more prevalent than is commonly recognized, particularly in older women and women who are not routinely tested. It is not included in standard screening panels for asymptomatic women in all guidelines, but is appropriate to test for when vaginal symptoms including discharge, itching, or odor are present and have not responded to prior treatment for BV or yeast.
Contact our office promptly if you experience:
- New genital sores, blisters, or ulcers
- Purulent vaginal discharge with pelvic pain or fever — possible PID
- A painless genital sore or rash on the palms or soles suggesting early syphilis
STI screening is a standard component of comprehensive women’s health care that protects health and prevents complications. It is not a reflection of sexual behavior, relationship status, or personal choices — it is a clinical tool for identifying common, often asymptomatic infections that have effective treatment when found. At Lapeer Women’s Health, STI screening is offered and discussed as the routine health care component it is.
Both our Lapeer and Rochester Hills offices are available for STI screening and sexual health care. No referral required.
Our team at Lapeer Women’s Health includes STI screening as part of comprehensive well-woman care at both our Lapeer and Rochester Hills offices. No referral required.
Schedule a Gynecologic VisitEducational purposes only. Not medical advice. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.