Chlamydia, Gonorrhea, and Syphilis

A sexually transmitted infection (STI) is an infection spread by sexual contact. There are many STIs. This FAQ focuses on chlamydia, gonorrhea, and syphilis. These STIs can cause long-term health problems and problems during pregnancy. Having an STI also increases the risk of getting human immunodeficiency virus (HIV) if you are exposed to it.

Chlamydia is the most common STI in the United States. Chlamydia is caused by bacteria that pass from person to person during vaginal, anal, or oral sex. These bacteria can infect the mouth, reproductive organs, urethra, and rectum. One common place of infection is the cervix (the opening of the uterus).

It is common to be infected with both chlamydia and gonorrhea at the same time.

The following factors increase the risk of getting chlamydia:

• Having a new sex partner

• Having more than one sex partner

• Having a sex partner who has more than one sex partner

• Having sex with someone who has an STI

• Having an STI now or in the past

• Not using condoms

• Exchanging sex for money or drugs

Chlamydia usually does not cause symptoms. When there are symptoms, they may show up a few days to several weeks after infection. They may be very mild and can be mistaken for a urinary tract infection (UTI) or vaginal infection.

If you do have symptoms, these are the most common:

• yellow discharge from the vagina or urethra, or any discharge that is different from your normal

• vaginal bleeding between menstrual periods or during or after sex

• painful or frequent urination

• rectal bleeding, discharge, or pain

A chlamydia test can be done on a urine sample or on samples taken with a swab from the vagina, mouth, throat, rectum, or the area around the cervix. You can do a self-swab of your vagina or rectum in the office of your obstetrician–gynecologist (ob-gyn) or other health care professional. You may also be able to self-test at home.

A yearly screening test is recommended if you are younger than 25 or if you are 25 and older and have risk factors for chlamydia.

Chlamydia is treated with an antibiotic. Your sex partners also need to be treated. This can often be done without them having to get tested (this is called “expedited partner therapy”) This includes anyone you have had sex with in the past 60 days or your last sex partner. Be sure to take all of your medicine as directed. 

Chlamydia can be passed to sex partners even during treatment. You should avoid sex until at least 7 days after you have finished treatment, and your sex partners should as well.

You should be retested for chlamydia 3 months after treatment to be sure the infection is gone. If you cannot be retested 3 months after treatment, you should be retested at a health care visit within the next year.

Untreated infection with chlamydia can lead to a condition called pelvic inflammatory disease (PID). This happens when bacteria move up from the vagina and cervix and into the uterus and fallopian tubes. Symptoms of PID may include chills, fever, and pelvic pain. Some people may not have symptoms until they have had PID for a while.

To learn more, read Pelvic Inflammatory Disease.

Gonorrhea is the second most common STI in the United States. Gonorrhea is caused by bacteria that pass to a partner during vaginal, anal, or oral sex.

It is common to be infected with both gonorrhea and chlamydia at the same time.

The following factors increase the risk of getting gonorrhea:

• Having a new sex partner

• Having more than one sex partner

• Having a sex partner who has more than one sex partner

• Having sex with someone who has an STI

• Having an STI now or in the past

• Not using condoms

• Exchanging sex for money or drugs

Gonorrhea often causes no symptoms or only very mild symptoms. They can be mistaken for a urinary tract or vaginal infection. 

If you do have symptoms, these are the most common:

• yellow vaginal discharge, or any discharge that is different from your normal

• vaginal bleeding between menstrual periods or during or after sex

• painful or frequent urination

• rectal bleeding, discharge, or pain

Gonorrhea tests can be done on a urine sample or on samples taken with a swab from the vagina, mouth, throat, rectum, or the area around the cervix. You can do a self-swab of your vagina or rectum in the office of your ob-gyn or other health care professional. You may also be able to self-test at home.

A yearly screening test is recommended if you are younger than 25 or if you are 25 and older and have risk factors for gonorrhea.

Gonorrhea is treated with two kinds of antibiotics. The recommended treatment is an injection of one antibiotic followed by a single pill of another antibiotic. If the injection is not available, you can take two types of antibiotic pills. This treatment is also effective against chlamydia. 

Your sex partners also need to be treated. This can often be done without them having to get tested (this is called “expedited partner therapy”). This includes anyone you have had sex with in the past 60 days or your last sex partner. Be sure to take all of your medicine as directed.

Gonorrhea can be passed to sex partners even during treatment. You should avoid sex until at least 7 days after you have finished treatment, and your sex partners should as well.

You should be retested for gonorrhea 3 months after treatment to be sure the infection is gone. If you cannot be retested 3 months after treatment, you should be retested at a health care visit within the next year.

Untreated infection with gonorrhea can lead to pelvic inflammatory disease (PID). This happens when bacteria move up from the vagina and cervix and into the uterus and fallopian tubes. Symptoms of PID may include chills, fever, and pelvic pain. Some people may not have symptoms until they have had PID for a while.

Untreated gonorrhea can also lead to disseminated gonococcal infection.

To learn more about PID, read Pelvic Inflammatory Disease.

Syphilis is caused by bacteria. The bacteria that cause syphilis enter the body through a cut in the skin or through contact with a partner’s syphilis sore. This sore is known as a chancre. Because this sore commonly develops on the vulva, vagina, anus, or penis, syphilis is most often spread through sexual contact.

The genital sores caused by syphilis also make it easier to get infected with and spread HIV. Syphilis can also be spread through contact with the rash that appears in later stages of the disease.

Symptoms of syphilis differ by stage:

• Primary stage—Syphilis first appears as a painless chancre. This sore goes away without treatment in 3 to 6 weeks.

• Secondary stage—If syphilis is not treated, the next stage begins as the chancre is healing or several weeks after the chancre has disappeared, when a rash may appear. The rash usually appears on the soles of the feet and palms of the hands. Flat warts may be seen on the vulva. There may be flu-like symptoms.

• Latent infection—In some people, the rash and other symptoms may go away in a few weeks or months, but that does not mean the infection is gone. It still is in the body. This is called latent infection.

Two blood tests are usually needed to diagnose syphilis. Routine testing for syphilis is not recommended for those who are not pregnant. But during pregnancy, you should be tested three times: at your first prenatal visit, in the third trimester, and at delivery.

Syphilis is treated with antibiotics. If it is caught and treated early, long-term problems can be prevented. The length of treatment depends on how long you have had the infection. You may have periodic blood tests to see if the treatment is working. 

You should avoid sex until you have finished treatment, and your sex partners should as well. Your sex partners should be treated for syphilis.

If you are diagnosed with syphilis, you should also be tested for HIV.

Untreated syphilis that returns years later can lead to problems with the brain, eyesight, heart, and nervous system. At this stage, syphilis can damage organs and even lead to death. If syphilis is caught early and treated, long-term problems can be prevented.

You can take steps to avoid getting chlamydia, gonorrhea, and syphilis. These safeguards also help protect against other STIs, including HIV:

• Use a latex or polyurethane condom every time you have vaginal, oral, or anal sex.

• Know your sex partners. The more partners you or your partners have, the higher your risk of getting an STI.

• Ask about your partner’s sexual history. Ask your partner whether they have had STIs.

• Avoid contact with any sores on the genitals.

• Get tested every year for chlamydia and gonorrhea if it is recommended for your age. If your ob-gyn does not offer you this screening, ask to be tested.

Telling sex partners that you have an STI and are being treated for it is called partner notification. It is an important step in treatment. When partners are treated, it helps reduce the risk of you being reinfected. 

You can tell your partners yourself, or you may be able to have the health care department in your state do it. If you choose to have the health department tell your partners, your name will not be used when the partner is told.

Antibiotic: Medication that treats or decreases the risk of certain infections caused by bacteria.

Anus: The opening of the digestive tract through which bowel movements leave the body.

Cervix: The lower, narrow end of the uterus at the top of the vagina.

Chancre [SHANG-kuhr]: A sore caused by syphilis that is found at the place of infection.

Chlamydia: A sexually transmitted infection caused by bacteria. This infection can lead to pelvic inflammatory disease and infertility.

Disseminated Gonococcal Infection [di-SEM-uh-nay-tuhd gah-nuh-KAH-kuhl]: An infection that may result from untreated infection with gonorrhea and can be life-threatening. Symptoms include fever, chills, skin sores, and pain in the wrists, fingers, knees, or toes.

Fallopian Tubes [fuh-LOH-pee-uhn]: Tubes through which an egg travels from the ovary to the uterus.

Genitals: The sexual or reproductive organs on the outside of the body.

Gonorrhea: A sexually transmitted infection that can lead to pelvic inflammatory disease, infertility, and arthritis.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system. If left untreated, HIV can cause acquired immunodeficiency syndrome (AIDS).

Menstrual Periods: The monthly shedding of blood and tissue from the uterus. Also called menstruation.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with medical and surgical training and education in the female reproductive system.

Pelvic Inflammatory Disease (PID): An infection of the uterus, fallopian tubes, or ovaries.

Penis: The male sex organ.

Rectum: The last part of the digestive tract.

Screening Test: Test that looks for possible signs of disease in people who do not have symptoms. If signs of disease are found, more testing may be needed.

Sexually Transmitted Infection (STI): An infection that is spread by sexual contact. Infections include chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Syphilis: A sexually transmitted infection (STI) that is caused by an organism called Treponema pallidum. This infection may cause major health problems or death in its later stages.

Urethra: [yu-REE-thruh]: A tube-like structure. Urine flows through this tube when it leaves the body.

Urinary Tract Infection (UTI): An infection in any part of the urinary system, including the kidneys, bladder, or urethra.

Uterus: A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Also called the womb.

Vagina: A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.

Vulva: The external female genital area.