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Possible Complications of STDs

By Jill Grimes, M.D., FAAFP ; Updated August 14, 2017

Sexually transmitted infections (STIs), also known as sexually transmitted diseases (STDs), include bacterial, viral and parasitic infections, so complications can vary anywhere from mild cosmetic issues to infertility to serious cancers and other life-threatening diseases. Early diagnosis and treatment are key to preventing complications in STIs. Be aware that the majority of STIs have no symptoms, so the only way to know you are infected is to be tested.

Bacterial STDs

Untreated chlamydia and gonorrhea infections have a high risk of complications. Between 10 and 30 percent of women infected with these STIs will develop pelvic inflammatory disease (PID), which is an infection that has spread up into a woman’s reproductive organs. The PID infection can become severe enough to cause sepsis and death, although that is a rare complication. More commonly, antibiotics will cure the infection, but problems still develop from internal inflammation and adhesions.

Approximately 10 to 20 percent of the time PID can produce scarring that causes infertility, along with chronic pelvic pain and ectopic (tubal) pregnancies. Because so many chlamydia and gonorrhea infections have few to no symptoms, it is critical for sexually active women to be tested regularly in order to detect and cure these STIs before permanent damage has occurred.

Human Papilloma Virus (HPV)

Some HPV strains may produce genital warts or cause HPV-related cancers. Genital warts by themselves do not typically cause severe medical complications, though they certainly are a major cause of stress, anxiety and self-esteem issues. Complications, such as secondary skin infections or scarring, may also occur as a result of topical or surgical treatments for genital warts.

Another rare complication of genital warts is called recurrent respiratory papillomatosis (RRP), which occurs when HPV is passed from an infected mother to her baby through the process of childbirth. About 2,000 babies are affected each year in the United States. These young children develop HPV growths on and around their vocal cords, which must be removed surgically.

HPV-related cancers include cervical, vaginal, vulvar, anal, penile and oropharyngeal (mouth and throat) cancers. Complications may arise during surgical treatment or chemotherapy, including infertility, cosmetic defects, secondary infections and even death.

Herpes Simplex Virus (HSV)

Common minor HSV complications are primarily secondary skin infections, which typically occur after scratching the skin and the blisters during an outbreak. HSV does not lead to infertility, but herpes can certainly create or contribute to painful intercourse or chronic pelvic pain.

In pregnancy, however, a new herpes simplex infection can have multiple complications, including miscarriage, early labor and premature babies and severe complications in the fetus if the infection spreads to the brain and nervous system. Herpes, meningitis, and encephalitis are usually fatal if not promptly treated. The good news is that although nearly a third of pregnant women have genital herpes, less than 0.1 percent of their babies develop neonatal herpes. If a pregnant woman is having a genital herpes outbreak at the time of her delivery, a C-section is typically performed to lessen the chances of herpes transmission to the baby.

Human Immunodeficiency Virus (HIV)

Because HIV attacks the immune system, early HIV complications often involve infections that would not typically cause disease in healthy adults. With the current advances in medical treatment, newly infected people with HIV may have many years to decades during which their disease is latent (inactive) and they have no complications. The end stage of HIV disease is called acquired immunodeficiency syndrome (AIDS), and at this point complications include many different opportunistic infections and cancers, any and all of which may be fatal.

Hepatitis B and C

Both hepatitis B and C viral infections may have minimal symptoms for years to decades, but long-term complications include liver scarring (cirrhosis), liver failure, liver cancer and, eventually, death.

Parasitic STD Complications

Trichomoniasis infections during pregnancy can cause pre-term delivery and low birth weights. Trichomoniasis infections greatly increase your risk of getting other STIs, especially HIV. This infection can cause discomfort or pain with intercourse, but trichomoniasis does not directly cause infertility.

Pubic lice and scabies cause a great deal of discomfort and itch, but typically the only complications come from secondary bacterial infections after scratching the affected areas. These infections do not lead to infertility.

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