Bacterial Infections of Female Reproductive Organs

Several infections of women's reproductive organs may cause pain, irritation or other symptoms. Because some of these infections frequently lead to infertility or present a serious health risk, all women should become familiar with and know how to prevent them. It is not uncommon to have more than one infection at the same time. Having any of these infections does not give you immunity against a future infection.

Chlamydia

Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. These bacteria can infect both men and women. Infection with chlamydia is the most common sexually transmitted infection among college-aged women. Chlamydia bacteria are carried in semen and vaginal fluids. In women, they infect the cervix and urinary tract. In men, they infect the urinary tract and the epididymis. In both genders, they can infect the rectum, the lining of the eye (an infection called conjunctivitis) and the throat through oral sexual contact.

Many people have no symptoms of infection. Early symptoms can be abnormal discharge, such as mucus or pus, from the vagina or pain while urinating.

Chlamydia can be treated with antibiotics. It is important that treatment be continued for the full course. All sexual partners should get tested and then treated if infected.   Untreated, chlamydia can cause pelvic inflammatory disease (PID).

Chlamydia infection can be prevented by abstaining from sexual contact or only having sexual contact within a long-term partner who is monogamous and who has been tested and is uninfected. In other situations, using latex condoms correctly and consistently during vaginal or rectal sex can reduce your risk of getting chlamydia.

Because chlamydia often causes no symptoms, health care experts recommend that all sexually active women 25 years old and younger get chlamydia screening tests at least once a year. They recommend an annual screening test for older women with risk factors for chlamydia; these risk factors include having a new sex partner or many sex partners. In addition, all pregnant women should have a screening test for chlamydia.

Gonorrhea

Gonorrhea is a serious sexually transmitted infection caused by bacteria called Neisseria gonorrhoeae. These bacteria can infect both men and women. They are carried in semen and vaginal fluids and infect the genital tract, mouth and rectum.

Symptoms of gonorrhea in women may be mild and easily ignored early in the infection. In women, early symptoms are bleeding during sexual intercourse; pain or burning when urinating; and bloody or yellow vaginal discharge. As the infection progresses in women, the symptoms include cramps and pain, bleeding between menstrual periods, vomiting or fever.

In women and men, symptoms of rectal infection are discharge, anal itching and painful bowel movements with red-colored blood in the feces.

Gonorrhea can be treated with antibiotics. It is important that treatment be continued for the full course. All sexual partners should get tested and then treated if infected.

Gonorrhea infection can be prevented by abstaining from sexual contact or only having sexual contact within a long-term partner who is monogamous and who has been tested and is uninfected. In other situations, using latex condoms correctly and consistently during vaginal or rectal sex can reduce your risk of getting gonorrhea.

In women, untreated gonorrhea can lead to PID. In both genders, it can spread through the bloodstream and infect the joints, heart valves or brain. 

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is a broad term that refers to a serious inflammation and infection of a woman’s pelvic organs, including the uterus, fallopian tubes and/or the ovaries, but also may occur in the abdominal lining. PID is caused by a sexually transmitted infection (STI), especially gonorrhea or chlamydia. PID can be clinical, in which case there are symptoms, or "subclinical," in which case there a few or no symptoms and a woman may not know that she has it. In the case of chlamydia, the infection is frequently unapparent but can still cause infertility.  

Symptoms of PID depend on the type of infection that causes it. These are typical symptoms:

• Vaginal discharge that may have an unpleasant odor

• Painful urination

• Painful intercourse

• Pain in the lower abdomen

• Abnormal uterine bleeding

• Fever and chills

• Nausea and vomiting

About 75 percent of women diagnosed with PID are sexually active and under the age of 25. The cervix, or opening to the uterus, of teens and young women is more vulnerable to STIs. These are other risk factors:

• Having more than one sexual partner

• Having a partner with gonorrhea or nongonoccocal urethritis

• Past or current gonorrhea or chlamydia infections

• Previous cases of PID

Untreated or inadequately treated infections that cause PID can turn normal tissue of the reproductive organs into scar tissue. Scarring can cause infertility; ectopic pregnancy, in which the embryo begins developing outside the uterus, a potentially fatal condition; or chronic pelvic pain lasting months or even years. These complications are more likely if you have repeated episodes of PID. As many as a quarter of women diagnosed with PID may develop complications.

If you have any of the symptoms of PID, talk with your health care provider, who can usually determine if that is the cause. PID can be treated with antibiotics. Severe cases may require hospitalization. It is crucial to take the full course of antibiotics your provider prescribes and to return to your health care provider after beginning to take antibiotics to make sure they are working.

An estimated one in four women who have PID will develop it again. Other than sexual abstinence, the best way to prevent getting PID is to limit yourself to one lifetime sexual partner. Barrier contraceptive methods such as male and female condoms are an alternative, although not as effective as a single, disease-free partner.

Bacterial Vaginosis

Bacterial vaginosis (BV) is a common infection resulting from either overgrowth of normal vaginal bacteria or as an infection with bacteria from outside the body. Although it is more common among women who have had vaginal sex, it is not clear what role sexual activity plays in the development of BV. BV is important from several aspects. It is uncomfortable for the woman who has it, and it can lead to PID. BV may also increase the risk of transmitting or acquiring HIV. In some studies, BV has been linked to increased rates of miscarriage and premature birth. Not all studies, however, support this.  Typical, and the most common, symptoms include vaginal discharge or a change in discharge, bad odor and itching, called pruritus. Less frequently encountered symptoms include burning with urination and discomfort or pain during or following intercourse.  Your health care provider can make a diagnosis by looking at your symptoms and examining your vaginal secretions. Once the diagnosis is confirmed, treatment is generally with oral antibiotics or antibiotics in a vaginal cream. As with any antibiotic, be sure to finish the entire prescription.

Syphilis

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Although the most common way to get syphilis is by having sexual contact with an infected person, the bacteria also can be passed from sores on the skin or mucous membranes -- usually your genital area, lips, mouth or anus -- to the mucous membranes or skin of a sexual partner.

If untreated, syphilis progresses through three stages. Its symptoms are similar to other diseases. The first symptom of the first phase, primary syphilis, is usually a small, round, painless ulcer called a chancre (pronounced "SHANG-ker") that appears from nine to 90 days after infection at the place where the bacteria entered your body. It disappears after three to six weeks. Lymph nodes near the chancre will swell. These symptoms may be mild and go unnoticed. The open sores of early syphilis make it easier to be infected with the HIV.

A symptom of the second phase, secondary syphilis, is a non-itchy rash, usually on the palms of the hands and soles of the feet. It may cover the whole body, however, or appear only in a few areas. Other common symptoms are sore throat, fatigue, headache and swollen lymph glands.

The latent, or hidden, phase begins after the second phase ends. There are no symptoms, and the risk infecting a sexual partner is low.

Late syphilis, or tertiary syphilis, does not occur in everyone who is infected. It can begin many years after the primary infection. In this stage, the bacteria can damage the heart, eyes, brain, nervous system, bones, joints or other organs. This damage causes mental illness, blindness, deafness, memory loss or other neurological problems, heart disease and death.

Treatment during the early phases is usually effective. Damage done by the infection in the later stages cannot be reversed.

Infection with syphilis can be prevented by abstaining from sexual contact or only having sexual contact within a long-term partner who is monogamous and who has been tested and is uninfected. In other situations, using latex condoms correctly and consistently during vaginal or rectal sex can reduce your risk of getting syphilis.