Which STI Causes Itching?

Sexually transmitted infections (STIs), sometimes referred to as sexually transmitted diseases (STDs), are spread through vaginal, oral, or anal sex. Some can even be passed through skin-to-skin contact. According to the Centers for Disease Control and Prevention (CDC), about 26 million new STI cases are reported each year, though many others go undiagnosed.

Without proper diagnosis and treatment, STIs can cause severe health problems and infect more people unknowingly. Learning the common STI symptoms can help you get the care you need early with the best results.

Some of the most common STIs cause itching and irritation in your genital area. While these symptoms can be a sign of other health conditions, such as skin problems, yeast infections, or even stress, they should prompt you to seek care.

This article discusses the STIs that cause itching, as well as other common symptoms. It also presents how each of these STIs is diagnosed and treated.

STIs That Cause Itching

There are more than 20 different types of STIs. Symptoms can range from mild to intense, depending on the type of disease you get. People also differ in their responses to a specific STI, which depends on factors such as other health conditions. This can make it challenging to determine what causes vaginal itching or itching surrounding the penis.

While genital itching and irritation can suggest one of several common STIs, only a healthcare provider can diagnose and treat the problem. Identifying the STI helps you begin treatment as early as possible to prevent transmission, reinfection, and complications.

Any ongoing genital itching should prompt you to consult your healthcare provider. Your problem may be a sign of many health problems or one of the following STIs:

Chlamydia

Chlamydia is a common STI caused by the bacterium Chlamydia trachomatis. In the United States, chlamydia is the most often reported bacterial infectious disease.

Chlamydia affects men in the urethra (where urine leaves the body), rectum, or throat. In women, the disease affects the cervix (opening to the womb), rectum, or throat. Women can also pass chlamydia to their babies during childbirth.

Symptoms

It's common for chlamydia to occur without symptoms, making it hard to know you have it. When symptoms do occur, they usually appear several weeks after you're infected.

Women who have chlamydia can have the following symptoms:

• Itching in the vaginal area
• Pain during urination
• Yellow vaginal discharge
• Bleeding between periods
• Lower abdominal pain

Men who have symptoms of chlamydia often experience the following problems:

• Burning or itching near the opening of the penis
• Burning sensation during urination
• Milky-colored discharge from the penis
• Painful swelling of the testicles

Diagnosis

Chlamydia is diagnosed by testing for the presence of the bacteria that cause the disease. Nucleic acid amplification tests (NAATs) are the most sensitive tests for detecting chlamydia and infections.

NAATs can be performed on the following types of samples:

• Urine sample
• Endocervical swab (a swab of the area around the opening of the uterus)
• Urethral swab (a swab of the tube in the penis through which urine passes out of the body)
• Vaginal swab (a swab of the vaginal walls)
• Pharyngeal swab (a swab of both sides of the back of your throat)
• Rectal swab (a swab of the interior of your rectum)

Treatment

If you're diagnosed with chlamydia, it's important to begin treatment as soon as possible. Chlamydia is a preventable cause of pelvic inflammatory disease (PID) and infertility. About 10%–15% of women with untreated chlamydia develop PID.

Chlamydia is treated with oral antibiotics. The CDC recommends the use of 100 milligrams of doxycycline twice daily for seven days to treat chlamydia. When doxycycline can't be used, a single 1-gram dose of azithromycin or a seven-day regimen of 500 milligrams of levofloxacin taken once daily is advised.

Gonorrhea

Gonorrhea, commonly called "the clap," is caused by Neisseria gonorrhoeae bacterium. It affects both men and women in the genitals, rectum, and throat. A woman who has gonorrhea can pass the infection to her newborn during childbirth.

More than 1.5 million new gonococcal infections occur in the United States annually. Gonorrhea ranks second to chlamydia as the most commonly reported bacterial infectious disease.

Symptoms

Gonorrhea doesn't always cause symptoms. When it does, the symptoms may be so mild that they go unnoticed.

With gonorrhea, itching is most likely to occur when the disease infects your anus. In addition to anal itching, symptoms of anal gonorrhea can include:

• Anal discharge
• Anal bleeding
• Soreness
• Pain during bowel movements

Generally, men are more likely than women to have symptoms of gonorrhea. These commonly begin within a week of infection and can involve the following symptoms:

• Yellow, white, or green discharge from the penis
• Pain or burning during urination
• Pain or swelling in the testicles

Most women don't get symptoms of gonorrhea. When problems occur, they usually appear within a week of infection. In women, symptoms of gonorrhea include:

• Pain or burning during urination
• Yellow or bloody vaginal discharge
• Bleeding between periods

Diagnosis

Gonorrhea is diagnosed by testing a sample of bodily fluids, usually urine, for the bacterium that causes gonorrhea. Samples for a gonorrhea test are taken from the area of suspected infection.

A diagnosis of gonorrhea requires confirmation via a microscope of gram-stained samples, a bacterial culture, or NAATs. The following types of samples may be used for these tests:

• Urine sample
• Mouth swab
• Rectal swab
• Urethral swab in men
• Cervical swab in women
  

Treatment

Treatment for gonorrhea is important for both women and men who want to protect their fertility. In women, untreated gonorrhea can infect the fallopian tubes or uterus, which can lead to PID, a cause of infertility. In men, the disease can cause inflammation of the testicle tubes (epididymitis), a rare condition that can also lead to infertility.

The high infection and reinfection rates of gonorrhea have caused the bacterium to develop resistance to most types of antibiotics. This complicates treatment because there are limited antibiotics that remain effective against the disease.

To try to prevent antibiotic resistance, treatment of gonorrhea involves the use of two antibiotics in the following regime:

• A single 500-milligram intramuscular or intravenous dose of ceftriaxone
• Oral doxycycline, given in two 100-milligram doses every day for seven days

Trichomoniasis

Trichomoniasis, commonly referred to as "trich," occurs as a result of infection with the protozoan parasite Trichomonas vaginalis. It is the most common nonviral STI.

The infection usually affects women in the lower genital tract in areas that include the vulva, vagina, cervix, or urethra. Men typically get infected in the urethra.

Symptoms

Like many other STIs, trichomoniasis can occur without symptoms. About 7 out of 10 people infected with the disease don't have symptoms.

When symptoms occur, they usually begin between five and 28 days of infection. Signs of the disease can also occur much later, or they may come and go.

Women who have symptoms of trichomoniasis usually experience vaginitis and report the following problems:

• Vaginal and vulval itching, burning, and soreness
• Yellow-green or gray vaginal discharge
• Vaginal odor
• Painful sex
• Pain during urination

While symptoms are rare in men, they usually involve urethritis and the following issues:

• Irritation or itching inside the penis
• Discharge from the penis
• Burning after ejaculation or urination
  

Diagnosis

There are several options for getting an accurate diagnosis of trichomoniasis. They usually involve the testing of vaginal or urethral secretions in one of the following techniques:

• Microscope analysis of a vaginal sample for the presence of T. vaginalis
• Cultures
• NAATs
  

Treatment

Trichomoniasis is treated with oral nitroimidazoles. Cream or lotion versions of these medications are not effective in eradicating the disease.

The CDC recommends the following nitroimidazoles for the treatment of trichomoniasis:

• For women: Metronidazole in a 500-milligram oral dose twice daily for seven days
• For men: Metronidazole in a single dose of 2 grams
• Alternative regimen for women and men: Tinidazole in a single oral dose of 2 grams

Genital Herpes

Genital herpes is an STI caused by the herpes simplex virus (HSV). There are two types of HSV—herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

Genital herpes can cause sores on your genital or rectal area, buttocks, and thighs. Although the risk is low, it can also be spread from an infected mother to her newborn baby.

Genital herpes is spread by having vaginal, oral, or anal sex with someone who has the HSV-2 infection. You can also get genital herpes from a partner who has oral herpes, which is caused by the HSV-1, and spreads it to your genital area via oral sex.

Symptoms

You can have genital herpes without having any noticeable symptoms. You can also confuse the symptoms with other conditions that range from pimples to the flu.

When symptoms occur, they involve blisters that appear on the vagina, vulva, cervix, penis, scrotum, buttocks, or anus. The blisters usually appear about two to 20 days after infection and may be accompanied by the following symptoms:

• Itching or painful sores
• Burning during urination or when urine touches the herpes sores
• Difficulty urinating due to sores that swell and block your urethra
• Genital pain

Genital herpes caused by HSV-2 can also resemble the flu in the first outbreak by causing the following symptoms:

• Fever
• Chills
• Swollen glands in the pelvic, throat, and underarm areas
• Headache
• Achiness and fatigue

Symptoms usually last for two to four weeks. During this time, the blisters rupture, ooze, crust over, heal, then usually reappear at a later time.

Diagnosis

If you have symptoms of genital herpes, consult a healthcare provider for an accurate diagnosis of your symptoms. A physical examination can often show signs of genital herpes.

A diagnosis of genital herpes can be confirmed by scraping a sample of skin, crust, or fluid from a lesion. The material is tested with one of the following techniques:

• NAAT
• Laboratory viral culture test

If you don't have symptoms of genital herpes but have concerns about having close contact with an infected person, a blood test may be used for diagnosis. If you have genital herpes, your blood will have evidence of antibodies used to fight the disease.

Treatment

While there is no cure for genital herpes, antiviral drugs can improve symptoms and reduce the severity and duration of an outbreak. The right treatment can also benefit sexual partners by reducing the risk of transmission.

The first outbreak of genital herpes can cause severe or prolonged symptoms. The CDC advises antiviral therapy with one of the following regimens for all people who experience their first episode of genital herpes:

• Acyclovir in a 400-milligram oral dose three times per day for seven to 10 days
• Famciclovir in a 250-milligram oral dose three times per day for seven to 10 days
• Valacyclovir in a 1-gram oral dose two times per day for seven to 10 days

If you have recurring outbreaks of genital herpes, you may benefit from suppressive therapy. This involves the use of acyclovir, famciclovir, or valacyclovir taken daily in a prescribed regimen. Suppressive therapy can reduce the frequency of outbreaks by 70% to 80% among people who have frequent attacks.

Some patients benefit from episodic therapy for genital herpes. This requires starting a prescribed regimen of acyclovir, famciclovir, or valacyclovir within one day of a genital herpes outbreak. You'll take these drugs for one to five days, depending on the dosage given.

Genital Warts

Genital warts, also known as condylomata acuminata, are a common STD that affects up to 360,000 people in the United States annually. They are caused by the human papillomavirus (HPV).

Genital warts usually develop on the labia, the area near the vaginal opening, in women. In men, they are most likely to appear at the tip of the penis or along the shaft. They can also occur in other genital areas of both sexes, including the anus.

Symptoms

Genital warts appear as whitish or skin-colored bumps that resemble cauliflower. They can occur alone or in bunches, and can vary in size. Genital warts can itch, but they usually aren't painful.

It can be hard to know when you got the infection, because symptoms can appear weeks, months, or even years after sexual contact with a person infected with genital warts.

Diagnosis

Genital warts can often be diagnosed with a physical exam during an office visit with your healthcare provider. In women, a Pap test may be used to evaluate cervical changes caused by genital warts.

No swabs or blood tests exist to diagnose genital warts. Part or all of the warts may be removed and sent to a laboratory for microscopic evaluation. While tests exist for HPV, they only test for HPV strains that pose the risk for cervical cancer, which does not include the strains of HPV that cause genital warts.

Treatment

While there is no cure for genital warts, there are several types of treatments that can reduce symptoms and the severity of your infection. Without treatment, genital warts may remain the same, change in size, or resolve spontaneously.

There are several options for treating genital warts. Some treatments are self-applied, while others are administered by a healthcare provider. The type of therapy you receive is based on the size, number and condition of your genital warts, as well as your preferences and other health conditions.

Patient-applied treatments for genital warts include:

• Imiquimod 5% cream
• Podofilox 0.5% solution
• Sinecatechins 15% ointment
  

Options for physician-applied treatments for genital warts include:

• Cryotherapy (freezing off warts)
• Interferon (injection into warts)
  
• Trichloroacetic acid
• Surgical removal
• Laser treatment
• Electrocautery (burning off warts)
• Podophyllin 25% solution

Summary

STIs are health problems that often occur without proper treatment. If you have an STI and ignore or delay the care you need, you may be risking your fertility and future health.

While itching is a common symptom of STIs, only a healthcare provider can define the source of your problem and the type of STI you have. Some STIs can be found with an exam, though most need a special test to confirm they exist.

Knowing STI symptoms can help you find these problems early. Getting the right care and treatment can help you reduce symptoms and protect your well-being.

A Word From Verywell

Having an STI can have both physical and emotional effects. Common STI symptoms, such as itching and pain, can cause discomfort and make it hard to function normally. From an emotional aspect, it's also common to feel embarrassed about seeking care or discussing the situation with your sex partner.

Start by seeking medical care for your symptoms. Getting an accurate diagnosis can help you get the right treatment and improve the way you feel both physically and emotionally. Seek support and referrals from your healthcare provider if you feel isolated by your condition.

Having an STI is relatively common and affects more people than you realize. With the right physical and emotional support, you can concentrate on healing and ways to reduce your risk of infection in the future.