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STD testing in the presence of symptoms
In this section, we explain what STD testing is necessary for various symptoms you might have. STD testing can be done anytime you're symptomatic. Here are a few things to keep in mind regarding testing:
A positive test is good for establishing a diagnosis of STD
A negative test means only that the STD being tested for isn't the cause of your current symptoms*
*If you want to know if you have any STDs after a sexual encounter, appropriate testing must be done after the incubation period for each specific STD.
The most common STD symptoms are discharge, urinary tract infection (UTI) symptoms (burning, urgency, and frequent urination), skin sores, and skin bumps. Let's talk about each of these in more detail..
Discharge that can be an STD
Certain body parts, such as the vagina, penis, and rectum, always have some discharge, which is normal lubrication produced by the body. So, what is abnormal discharge?
A combination of two things makes discharge abnormal
1. Fluid dripping spontaneously (without squeezing)
2. Fluid that's different from the normal fluid (the baseline)
These are the example of discharges that are different from the baseline:
- New discharge
- More discharge than normal
- Different consistency (thicker or thinner)
- Different color (yellow, greenish, blood-tinged)
- Unusual smell (fishy)
Male penile discharge
What is a penile discharge?
Penile discharge is spontaneous fluid coming out of the penis (without squeezing). Sometimes the discharge is minimal and one or more of these can help you notice it:
- Staining of the underwear
- The urine stream being split (caused by discharge that has dried at the penile opening)
- Pain with urination (burning at the tip or along the penis)
What STD test can be done for abnormal penile discharge?
1. Most common STDs need to be ruled out:
- Chlamydia
- Gonorrhea
2. If chlamydia and gonorrhea tests are negative, other tests are going to be necessary:
- Mycoplasma*
- Ureaplasma*
- Trichomoniasis*
- None of these three conditions are common in males, and tests for them are not commonly performed
STD test types for penile discharge
- Urine test
- Penile swab
Rectal discharge
What is rectal discharge?
Any rectal discharge (fluid coming out of rectum spontaneously) is considered abnormal. For people who practice anal sex, STDs need to be ruled out as a cause of the rectal discharge
What test can be done for abnormal rectal discharge?
- Chlamydia
- Gonorrhea
STD test types for rectal discharge
- Rectal swab can be done (by doctor or self-swab)
Female vaginal discharge
What is abnormal vaginal discharge?
Abnormal vaginal discharge is any discharge different from baseline (the vagina normally has discharge, which is different from person to person; every woman knows her baseline), including the following:
- A new type of discharge
- More discharge
- Different consistency discharge (thicker, thinner)
- Different color discharge (yellow, greenish, blood stinged)
- Unusual smell (fishy)
What STD tests can be performed for abnormal vaginal discharge?
Vaginal discharge can be caused by STDs and non-STDs
1. The following test are done for vaginal discharge.
- Chlamydia
- Gonorrhea
- Trichomoniasis
- Mycoplasma
- BV (bacterial vaginosis)
- Yeast (candidiasis)
2. If the above tests are all negative swab for Ureaplasma can be done.
It can be part of the normal vaginal flora in females with more than one life time sex partner and for that reason test not done routinely but when other causes of vaginal discharge are excluded. Occasionally Ureaplasma can overgrow causing symptoms.
STD test types for abnormal vaginal discharge
- Vaginal swab is the preferred test
- Urine test is an alternative test and might not pick up the infection
- The urine test can be done with the presence of urinary symptoms (burning urgency and increased frequency with urination) or for routine screening (no symptoms)
"UTI" symptoms that can be an STD
"UTI symptoms" are burning, urgency and increased frequency with urination can be the sign of various STDs. It can be a sign of STDs for both genders but predominantly males.
The most reliable (doctors trust the most) "UTI symptoms" suggestive of STDs, out of three (burning, urgency and increased frequency with urination), is burning of the urethra during urination.
The burning can be at the tip, along the urethra or in the bladder area (lower abdominal region) at the time of the urination.
Most common STDs conditions that caused by "UTI symptoms"
- Chlamydia
- Gonorrhea
- Trichomoniasis
- Mycoplasma
- Ureaplasma
*Because of different genital anatomy for male and females the "UTI symptoms" means different things. For that reason we separated male with "UTI symptoms" from female
Male with "UTI" symptoms that can be an STD
Most common STDs that need to be ruled out for "UTI symptoms" (burning, urgency and increased frequency with urination) in male are:
- Chlamydia
- Gonorrhea
If the chlamydia and gonorrhea ruled out other STDs and non-STDs that are less common need to be considered:
- Mycoplasma
- Trichomoniasis
- Ureaplasma
- UTI
- Prostatitis
STD test types for male "UTI symptoms"
- Urine test
- Penile swab
Female with "UTI" symptoms that can be an STD
STD tests that can be performed for females with "UTI symptoms"
Most common condition for "UTI symptoms" for females is the bladder infection.
As far as STDs concerned, most common STDs that need to be ruled out for "UTI symptoms" (burning, urgency and increased frequency with urination) in female are:
- Chlamydia
- Gonorrhea
- Mycoplasma
- Trichomoniasis
If the above-mentioned STDs are ruled out other condition such as Ureaplasma need to be considered
STD test types for female "UTI symptoms"
- urine test (first catch urine)
- vaginal swab
Throat pain that can be an STD
Throat pain can be a sign of a STD. Some STDs stay at the point of contact, and only testing of that area can pick up the infection.
What STDs can cause sore throat?
- Chlamydia
- Gonorrhea
STD test types for throat pain
- Throat swab.
Rectal pain that can be an STD
Rectal pain can be a sign of STD especially if person practice receptive anal sex (being a "bottom"). Some STDs stay at the point of contact, and only testing of that area can pick up the infection.
What STD tests can cause rectal pain?
- Chlamydia
- Gonorrhea
- Herpes
STD test types for rectal pain
- Rectal swab for chlamydia and gonorrhea
- Rectal sore swab for herpes (if sores are visible)
Genital bumps that can be an STD
What is genital bump?
Any type of skin swelling or lump on the genital is considered a bump. It can be itchy and have different colors.
What STDs present as genital bumps?
Two most common STDs that present as a bump are:
- Genital wart (caused by HPV)
- Molluscum contagiosum
STD test types for genital bumps
- Both genital wart and molluscum contagiosum can be diagnosed clinically by a doctor by checking the visual appearance
- Skin biopsy can be done at a specialized health center if necessary to confirm the conditions.
Genital sores that can be an STD
The two most common sexually transmitted infections that cause genital sores are herpes and syphilis. Taking a history (asking the patient about symptoms and signs and how they evolved over time) and performing a physical examination both play a big role in diagnosis of these conditions, but this is beyond the scope of this article. Here we will talk about what tests are available to try to rule out STDs if genital sores are present
What STD tests can be done for genital sores?
- Chlamydia
- Gonorrhea
STD test types for genital sores
- Rectal sore swab for herpes.
Herpes swab can be done while sores are present and wet. The test is accurate if it is done at the right time and under the right conditions (performed in a reliable testing center. Please, read about the intricacy of the herpes skin swab here - Syphilis sore.
Syphilis sore can be diagnosed visually by an experienced doctor. But the biopsy or the blood test (in 6 weeks) is necessary to confirm the syphilis sore. Read about syphilis testing here
