Often, the Signs of Illness Aren’t Obvious

Women responding to a recent Kaiser Family Foundation survey, published in October’s Glamour magazine, overwhelmingly considered themselves “not at all” at risk for sexually transmitted diseases. Unfortunately, many of these women were wrong.

In fact, one in four women will get an STD in her lifetime. Often, she will remain unaware of her infection until the disease progresses into dangerous complications. These dual characteristics--silent initial infection and potentially severe complications--make STDs a significant threat to women’s reproductive health.

One of the most common and dangerous STDs for women is chlamydia, a disease many people haven’t heard of. Now at epidemic levels, chlamydia is the leading preventable cause of female infertility in the United States.

A bacterial infection transmitted during vaginal or anal sex, chlamydia causes no initial symptoms in up to 80% of infected women. Consequently, the infection often goes undetected and untreated for months or years, during which time it can spread to the uterus, Fallopian tubes and ovaries. This condition, known as pelvic inflammatory disease, or PID, occurs in up to 40% of women with untreated chlamydia. PID can cause life-threatening ectopic tubal pregnancies, chronic pelvic pain and infertility. In fact, more than 100,000 women in the U.S. become infertile each year from STD-related PID. All of these complications are preventable, since chlamydia is easily cured with antibiotics.

Another extremely common STD affecting women is human papillomavirus, or HPV. This virus is transmitted through direct contact with infected skin or mucous membranes in the genital area. Though treatable, HPV infection cannot be cured and is widespread among sexually active adults. At least 100 million people in the U.S. have been infected.

There are dozens of HPV strains. Some cause genital warts, which can be unsightly and difficult to remove, but the most dangerous strains of HPV cause no visible signs. Instead, these strains can lead to cervical cancer, which kills nearly 5,000 women in the U.S. each year. A Pap smear is the best way to detect cervical cancer or abnormalities in cervical cells that can lead to it.

In addition to chlamydia and HPV, other STDs affect millions of women each year. These STDs include herpes, which can cause painful recurrent sores; gonorrhea, which can result in PID and other complications; and trichomoniasis, hepatitis B and syphilis.

And the women themselves aren’t the only ones in danger from the STDs they carry: Many of these infections can lead to serious complications in newborns, including premature birth and brain damage.

The good news about chlamydia and most other STDs is that a woman can vastly reduce her risk of infection by using a latex or polyurethane condom every time she has sex.

* Karen Bernstein is the project coordinator for the Infertility Prevention Project of the Los Angeles County STD Program. Dr. Robert Settlage is the medical director for the program.