Medically reviewed by Andrea Sleeth, WHNP-BC
Did you know that 3 of the most common STIs in the US can also lead to infertility if left untreated? Chlamydia, gonorrhea, and trichomoniasis are often considered “harmless” since they can often be cured with a simple round of antibiotics, unlike herpes or HIV. However, these 3 STIs can also easily slip under your radar undetected and if left untreated, can interfere with your ability to have children. There are millions of new infections each year, yet most of them remain asymptomatic—without regular screening, it’s very easy not to know you have an STI.
The good news is that if you do test positive, these STIs are all treatable. Treating early is key to protecting your health and the health of your sexual partners!
According to the CDC, chlamydia is the most commonly reported bacterial STI in the US. Young people are especially at risk, with almost two-thirds of all reported chlamydia cases being youths between the ages of 15 and 24. The CDC and US Preventive Services Task Force recommend that women under 25 be tested every year because asymptomatic cases are so common and people with internal reproductive organs are at high risk of negative long term impact when this STI is left untreated. Untreated, about 10-15% of women with chlamydia will develop Pelvic Inflammatory Disease, or PID. Chlamydia can also cause fallopian tube infection without any symptoms. The resulting inflammation and scarring from these reproductive infections can lead to trouble becoming pregnant.
Chlamydia can be spread via oral, anal, or vaginal sex and the best way to protect yourself is with a barrier method, like a condom, and get screened regularly regardless of whether or not you have symptoms. We know you’ve heard it before, but condoms are extremely effective at protecting you from STIs like chlamydia! If you do get an infection and experience symptoms, you’re most likely to feel pain during intercourse, burning or discomfort during urination, and pain in the lower abdomen. Getting tested and getting the right treatment quickly will protect you from long term effects on your fertility down the road.
Gonorrhea and chlamydia often go hand in hand, with gonorrhea also most affecting young people between 15 and 24. Recent data shows that rates of gonorrhea have increased 10% since 2019, and gonorrhea is especially concerning because it shows high rates of antibiotic resistance. Currently, the CDC estimates that at least half of all gonorrhea infections each year are resistant to at least one antibiotic. As with chlamydia, gonorrhea is often asymptomatic and the best way to protect your health is by using condoms and participating in regular screening.
Like chlamydia, gonorrhea can also lead to PID if left untreated and lead to difficulty becoming pregnant. In some cases, it may also increase your risk of an ectopic pregnancy if the fallopian tubes become damaged. While women are especially at risk for fertility issues related to gonorrhea, men can also be affected by untreated infections that lead to epididymitis (inflammation of the epididymis that causes testicular pain). If you do experience symptoms of gonorrhea, they often include unusual discharge, pelvic pain, and bleeding between periods. Get tested regularly and get treatment quickly to protect your fertility.
Also known as “trich,” trichomoniasis isn’t a bacterial infection—it’s actually caused by a parasite called Trichomonas vaginalis. In the United States, there were an estimated 2.6 million trichomoniasis infections in 2018, but only about 30% of these people will experience symptoms of infection. Unlike chlamydia and gonorrhea, older women are more likely than younger women to have this infection. Trichomoniasis can increase the risk of getting or spreading HIV, and pregnant women with the infection are more likely to have their babies too early (preterm delivery) and with a low birth weight.
If you are part of the 30% of people who experience symptoms with a trich infection, they may include genital itching and burning, unusual discharge, and discomfort during urination. Untreated trich can also lead to PID that can cause infertility and if you are pregnant, trich does increase your risk of preterm labor. Luckily, condoms do prevent trichomoniasis transmission and treatment is a straightforward oral medication.
Remember, with all 3 of these STIs it is possible to become reinfected if your partner is not treated at the same time and you do not use condoms. If you test positive for any of these STIs, you may request a “partner dose” from your provider to take to your partner so they may receive treatment as well, without having to make their own doctor’s appointment. That way your health and their health can be protected and taken care of.
If you’re on a fertility journey, check out Rescripted for resources, community, and support. There you’ll be able to shop for fertility care, talk with others navigating fertility and pregnancy, and get answers to your most common (and uncommon) fertility questions.