Beware of Asymptomatic Sexually Transmitted Infections!

Sexually transmitted infections do not always present with noticeable complaints. While some infections can progress for months without showing symptoms, the person may transmit the infection to their sexual partners without realizing it. Urology Specialist Prof. Dr. Berkan Reşorlu points out that the absence of symptoms does not mean the infection is not present, emphasizing the importance of early diagnosis and appropriate screening.

According to World Health Organization data, more than one million curable sexually transmitted infections are acquired every day worldwide among the 15-49 age group. Since infections such as chlamydia, gonorrhea, syphilis, HPV, genital herpes, HIV and hepatitis B can progress without symptoms for a long time in some individuals, early diagnosis and protective practices are important.

Why Don't Sexually Transmitted Infections Show Symptoms?

The characteristics of the microorganism, the response given by the immune system, and the anatomical region where the infection is located can be effective in the asymptomatic course of infections. Some infections can progress without causing noticeable inflammation; therefore, complaints such as burning during urination, genital discharge or pain may not be observed.

In particular, chlamydia and gonorrhea infections can continue without symptoms. The presence of the infection in the throat or rectal area can also cause the person not to feel any discomfort. In HPV infection, genital warts may never occur, while HIV infection may also go unnoticed in the early period.

Therefore, it is not correct to conclude that there is no infection based solely on physical symptoms.

Chlamydia and Gonorrhea Can Progress Silently

Chlamydia infection, caused by the Chlamydia trachomatis bacterium, can be seen in both women and men. The infection, which can cause urethritis by affecting the urinary tract in men, does not always produce symptoms such as discharge or burning during urination. It may also go unnoticed for a long time in women.

Untreated chlamydia can progress to the upper genital system in women, leading to pelvic inflammatory disease. This condition is associated with outcomes such as damage to the tubes, increased risk of ectopic pregnancy, and infertility.

Gonorrhea, commonly known among the public as 'bel soğukluğu', is caused by the Neisseria gonorrhoeae bacterium. Although the infection can present with symptoms such as discharge and burning during urination, it can be asymptomatic especially in women, or when located in the throat or rectum. Untreated gonorrhea can also cause complications affecting reproductive health in some patients.

Since antibiotic resistance is a significant problem in gonorrhea treatment, treatment should be planned with physician evaluation. Unconscious antibiotic use can negatively affect treatment and contribute to the development of resistance.

HPV and HIV Infections Can Progress Without Symptoms

Human Papillomavirus (HPV) is one of the common viral infections that can be transmitted through sexual contact and close genital skin contact. While some HPV types cause genital warts, high-risk types are associated with certain cancers of the cervix, anus, penis and oral-throat region.

A significant portion of HPV infections can be brought under control by the immune system without causing symptoms. However, the persistence of some infections can cause cellular changes in the long term. The absence of genital warts or a visible lesion in men does not definitively rule out HPV infection either.

In HIV infection, flu-like symptoms such as fever, sore throat, fatigue and swollen lymph nodes may be seen in the early period. However, some people may not show any symptoms at all, and the infection may go unnoticed for a long time.

HIV diagnosis is made not by looking at symptoms, but through tests performed at the appropriate time. Today, HIV infection can be effectively controlled with antiretroviral treatments. If less than 72 hours have passed since the risky contact, the need for HIV post-exposure prophylaxis (PEP) should be urgently evaluated.

Even If Syphilis Symptoms Disappear, the Infection May Continue

Syphilis, caused by the Treponema pallidum bacterium, is an infection that can progress through different stages. In the first stage, a painless sore usually forms at the site where the infection entered the body. However, the sore being located inside the mouth, in the rectum, or in a hard-to-notice area can cause the person to overlook it.

The sore healing on its own does not mean the infection has disappeared. Syphilis can transition into a latent period where no distinct clinical findings are seen, and it can be detected through blood tests at this stage. When left untreated, the nervous system, eyes, heart and vascular system can be affected in some individuals in later years.

Early diagnosis and appropriate antibiotic treatment play an important role in preventing complications related to syphilis.

Can Asymptomatic Infections Cause Infertility?

Some sexually transmitted infections can negatively affect reproductive health if left untreated. In particular, chlamydia and gonorrhea can progress to the upper genital system in women, leading to pelvic inflammatory disease. This condition can cause damage to the tubes, infertility, and an increased risk of ectopic pregnancy.

In men, some infections can affect a structure called the epididymis, which is involved in sperm transport. If epididymitis develops, pain and swelling may be seen around the testicles.

However, it cannot be said that every sexually transmitted infection will definitely lead to infertility. Early diagnosis and appropriate treatment can help prevent the progression of the infection, contributing to the protection of reproductive health.

Should People Without Complaints Also Get Tested?

The need for screening for sexually transmitted infections is determined according to the person's age, sexual history, number of partners, protection habits, and other risk factors.

It is important for individuals who have had unprotected sexual contact, whose partner has been diagnosed with an infection, or who have a new sexual partner, to consult a health specialist regarding appropriate tests. In certain age and risk groups, regular screening may be recommended even if there are no symptoms. The type and frequency of tests are planned according to the person's risk status.

It is not necessary to apply the same tests to every individual at the same frequency. Appropriate screening, especially during pregnancy and in certain risk groups, can help with the early detection of infections.

Which Tests Are Used to Detect Sexually Transmitted Infections?

Laboratory tests play an important role in the diagnosis of asymptomatic infections. The test to be used is determined according to the suspected infection and the characteristics of the sexual contact.

- Chlamydia and gonorrhea: Nucleic acid amplification tests can be performed using urine samples or swabs taken from appropriate areas.

- HIV, syphilis and hepatitis B: Blood tests are used in the diagnostic process.

- Evaluation after oral or anal contact: Samples can also be taken from the throat or rectal area when necessary.

The timing of tests is also important for diagnostic accuracy. Since the window period differs for each infection, some tests performed immediately after risky contact may give a negative result without definitively ruling out the infection. Which test should be performed when, and whether a repeat test is needed, should be determined through expert evaluation.

What Should Be Considered to Protect Against Sexual Infections?

To protect against sexually transmitted infections, it is important to use correct protection methods, get the necessary vaccinations, and evaluate testing in case of risk.

Condom use can reduce the risk of transmission of infections such as chlamydia, gonorrhea and HIV. However, it may not provide complete protection against infections transmitted through skin contact, such as HPV and genital herpes. HPV and hepatitis B vaccines are also among the important protective health practices against infections caused by these viruses.

If an infection is detected, completing the treatment in accordance with the physician's recommendation and, when necessary, evaluating sexual partners as well, can reduce the risk of reinfection. In particular, the use of antibiotics without a doctor's recommendation is not advised for bacterial infections.

Early Diagnosis Is Important for the Protection of Sexual Health

Asymptomatic sexually transmitted infections can cause a person to carry the infection for a long time without being aware of the disease and to transmit the infection to others. The absence of physical complaints in infections such as chlamydia, gonorrhea, syphilis, HPV and HIV does not mean there is no health risk.

In these infections, which are addressed within the field of expertise of Urology Specialist Prof. Dr. Berkan Reşorlu, it is important for individuals to be evaluated not only according to their current complaints, but also in line with their sexual contact history and individual risk factors.

Individuals with a history of risky contact getting tested at the appropriate time without waiting for symptoms can help with the early detection of infections. Early diagnosis, correct treatment, evaluation of partners, and protective health measures play an important role in protecting both individual sexual health and public health.