Let’s get to the bottom of this…
Anal chlamydia and gonorrhea are here to debunk the common myth that when sexually transmitted diseases strike, your vagina will let you know. No matter what you’ve heard before, STDs can affect many body parts, including your vagina, your mouth (herpes-induced cold sores, anyone?), and yes, your anus. But since people often don’t expect to get STDs, much less ones that show up anally, it’s easy to miss the signs you may have contracted one, doctors say. Here, a quick primer on what to look for, plus some essential tips on how to stay safe.
There are various types of anal STDs, but some are more obvious than others.
One STD that can present anally is herpes, an extremely common infection caused by either the herpes simplex 1 or herpes simplex 2 virus. The latter is usually (but not always) behind genital herpes, which affects around 1 out of every 6 people between the ages of 14 and 49, while around two-thirds of the global population under 50 has HSV-1. Sometimes herpes is asymptomatic, but if you get it anally and you actually have symptoms, you’ll notice the STD’s characteristic lesions. They’re usually painful and look like little blisters, so they’re hard to ignore, board-certified doctor of internal medicine Ehsan Ali, M.D., of Beverly Hills Concierge, tells SELF.
Same goes for getting an anal infection of human papillomavirus, the most common sexually transmitted disease. One in four Americans, or around 80 million people, have HPV, according to the Centers of Disease Control and Prevention. In addition to causing cervical, vaginal, penile, and mouth and throat cancers, HPV can cause genital or anal warts that look like little pieces of cauliflower, Ali says.
Anal chlamydia and gonorrhea, on the other hand, aren’t always so easy to spot.
Chlamydia and gonorrhea are far from rare. Chlamydia is the most commonly reported STD in the United States, especially in women 25 and under, and gonorrhea is also big in that age group. Although these STDs are often asymptomatic, typical signs of having one vaginally include pain or burning when urinating, increased vaginal discharge that might look or smell abnormal, and vaginal bleeding between periods.
Anally, chlamydia and gonorrhea work a bit differently. “The signs aren’t as well known as other traditional STD symptoms, like burning when you urinate,” Ali says. Instead, he explains, one of the most common symptoms is persistent, watery diarrhea—aka, a usual symptom of something like a stomach bug or case of food poisoning you think you just have to wait out.
There may also be rectal pain and bleeding, along with discharge that’s yellow or gray in color, potentially with an odor, ob/gyn Sherry Ross, M.D., tells SELF. On top of that, you might experience anal itching or burning, Ali says.
Although anal STDs are most commonly seen in men who have sex with other men, anyone who has anal sex is susceptible, which is why safe sex is so important.
As Ross points out, “a lot of women don’t insist their partners wear condoms during [anal sex] because they can’t get pregnant.” Even if all the action is going down anally, safe sex is necessary unless you’ve both been tested and are absolutely sure you’re not at risk for passing STDs to each other. “Be adamant about condom use,” Ross says.
Whether you’ve been tested or not, whenever you’re transitioning from anal sex to vaginal sex, definitely use a condom. (If you use a condom for both, always use two separate rubbers for each of the main events.) If you do have something like anal chlamydia or gonorrhea, that will prevent it from spreading to your vagina and internal reproductive organs, where it can ultimately cause pelvic inflammatory disease, which can impede fertility. Otherwise, having your partner don a condom after anal sex, but before vaginal intercourse, will help you avoid getting a UTI or an infection like bacterial vaginosis.
If you have any strange anal symptoms, even something that seems as innocuous as a mild case of diarrhea that won’t let up after four to five days, head to your doctor for testing.
You can see an ob/gyn, but you can also talk to your primary care doctor since the symptoms here are a little less clear-cut. “We’ll typically do a swab and do a culture,” Ali says. “If it shows that it’s [chlamydia or gonorrhea], we’ll give antibiotics to treat that.” And if not, your doctor will still be able to help you figure out what’s going on.