While both men and women in the U.S. are diagnosed with sexually transmitted infections (STIs) in about equal numbers, they are not affected by STIs equally. For example, women are more likely than men to experience long-term health complications from untreated STIs, including infertility (the inability to have a baby). A pregnant woman can also pass an STI along to her baby during pregnancy or childbirth.
There are a number of reasons why STIs have a greater impact on women:
Anatomy: A woman’s anatomy alone makes her more vulnerable to sexually transmitted infections than a man. Unlike the relatively thick skin of the penis, a woman’s vagina is covered by a thin, more delicate mucous membrane that more easily allows viruses and bacteria to pass through—and cause infection. The vagina is also a warm and moist environment, the type of environment that encourages bacteria to grow.
Lack of symptoms: Women are less likely than men to have symptoms of some common STIs, like chlamydia and gonorrhea, and as a result, they are less likely to seek care and get treatment. When STIs are untreated, they can cause serious, lifelong health problems (see more below). Even when women do have symptoms, they may not recognize these as symptoms of an STI. After all, vaginal discharge can be normal and not a sign of infection, and itching and irritation can be the result of a yeast infection or even a new type of laundry detergent. Symptoms are never a reliable way to know if someone has an STI, and since women so often have no symptoms at all, regular testing is important for sexually active women (and men).
Long-term health complications: This is yet another area where women face more problems than men. STIs like chlamydia and gonorrhea, if unnoticed and untreated, can lead to the condition Pelvic Inflammatory Disease (PID) in women. PID can lead to chronic pelvic pain, ectopic pregnancy (a pregnancy that develops in the fallopian tubes instead of the uterus and is life threatening to the mother), and infertility (the inability to become pregnant or carry a child).
Infection with high-risk HPV can also cause serious consequences for women if undetected and untreated. High-risk HPV can cause changes in the cervix that can lead to cervical cancer if untreated. The good news, however, is that cervical cancer is preventable with regular screening and vaccination.
Problems during pregnancy: STIs pose a number of serious risks to a pregnant woman’s unborn child, from low birth weight, brain damage, blindness, deafness, and even stillbirth (death of the child). STIs can pass from the mother to the baby during pregnancy and during delivery. For this reason, the Centers for Disease Control and Prevention (CDC) recommend that pregnant women be tested on their first prenatal visit for STIs, including chlamydia, gonorrhea, syphilis, HIV and hepatitis B. While there is a risk that women with herpes and HIV can pass infection on to the baby, there are steps they can take to greatly reduce this risk.