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STD Symptoms in Women: Signs, When to Test and Where in St. Louis

Updated · Sources are cited in the text

STD Symptoms in Women: Signs, When to Test and Where in St. Louis

This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

Many sexually transmitted infections (STIs) cause no symptoms at all. Others cause signs that are easy to mistake for something ordinary, like a yeast infection or a urinary tract infection. That is why this guide covers two things: the signs that deserve attention, and the reasons to get tested even when you feel fine.

This page is for women of every age, orientation and gender history, including trans women, nonbinary people with a vagina, and anyone who has sex with women, men or both. It is also for St. Louis readers who want to know where to go. Free and low-cost options exist in the city and the county.

Nothing here can tell you whether you have an infection. Only a test and a clinician can. What this guide can do is help you decide when to book one.

Key Takeaways

  • Many STIs, including chlamydia, gonorrhea, trichomoniasis, herpes, HPV and early HIV, can cause no noticeable symptoms, according to the CDC.
  • Not having symptoms does not mean a test is unnecessary. A clinician or a test result is the only way to know.
  • Signs that are worth a visit include unusual discharge, burning with urination, pelvic or lower belly pain, bleeding between periods, sores, bumps, itching, and pain during sex.
  • Untreated chlamydia and gonorrhea can lead to pelvic inflammatory disease (PID), which can affect fertility. Bacterial STIs are curable with treatment from a clinician.
  • Severe pelvic pain, fever with pelvic pain, or symptoms during pregnancy are reasons to be seen the same day.
  • In St. Louis, the City of St. Louis Health Stop offers free STI and HIV testing, and no ID is needed, according to the city. Other clinics offer sliding scale or low-cost care.

Table of Contents

  1. Why Most STIs Do Not Announce Themselves
  2. STD Symptoms in Women: What to Watch For
  3. Pelvic Inflammatory Disease and Fertility
  4. When to Get an STD Test for Women
  5. When to See a Clinician the Same Day
  6. Where to Test in St. Louis
  7. What Happens at a Visit and After Results
  8. Sources

Why Most STIs Do Not Announce Themselves

People often search for the symptoms of STDs in females because they want a checklist. A checklist helps, but it has a built-in limit. The CDC states that many STIs have no symptoms or only mild ones. A person can carry an infection for months or years without a single sign.

Here is what the CDC says about several common infections:

  • Chlamydia: The CDC says most people with chlamydia have no symptoms. When symptoms do appear, they can be mild.
  • Gonorrhea: Women often have no symptoms, or mild ones that can be mistaken for a bladder or vaginal infection, according to the CDC.
  • Trichomoniasis: The CDC reports that many people with trichomoniasis have no symptoms.
  • Genital herpes: The CDC notes that most people with herpes have no symptoms or very mild ones that go unnoticed or get mistaken for another skin condition.
  • HPV: The CDC says most HPV infections have no symptoms and often clear on their own.
  • HIV: Some people have a flu-like illness in the first weeks. Others have nothing for years, per the CDC.
  • Syphilis: Early sores can be painless and easy to miss, especially inside the vagina or on the cervix, according to the CDC.

This is the reason screening exists. Testing looks for infection before symptoms show up, and sometimes instead of symptoms ever showing up.

It also means that a past partner can pass on an infection without knowing it. Having an STI says nothing about your character or your choices. It is a common health event, and testing is routine care.

STD Symptoms in Women: What to Watch For

When symptoms do happen, they tend to fall into a few groups. None of the signs below point to one specific infection on their own. Many have non-STI causes, such as yeast infections, bacterial vaginosis, urinary tract infections, skin irritation or hormone changes. A clinician can sort out which is which.

Changes in vaginal discharge or odor

Discharge that changes in color, amount, texture or smell is one of the most common reasons people seek care. Chlamydia, gonorrhea and trichomoniasis can all cause discharge changes, according to the CDC. So can conditions that are not sexually transmitted. A new smell or a frothy, yellow-green or gray discharge is worth mentioning to a clinician rather than guessing.

Burning or pain with urination

Burning when you pee can come from a urinary tract infection. It can also come from chlamydia, gonorrhea, trichomoniasis or a herpes outbreak. If you have been treated for a urinary tract infection and the burning does not improve, it is reasonable to ask about an STI test too.

Pelvic or lower abdominal pain

A dull ache or sharper pain in the lower belly can have many causes. In the context of an STI, the CDC lists lower abdominal pain as one possible sign of pelvic inflammatory disease. Pain during sex, especially deep pain, can be another. More on this in the next section.

Bleeding between periods or after sex

Spotting between periods or bleeding after sex can be linked to infections of the cervix, including chlamydia and gonorrhea, according to the CDC. It can also come from hormonal birth control, cervical changes, polyps and other causes. Any new pattern is worth a conversation with a clinician.

Sores, blisters, bumps or ulcers

Genital herpes can cause blisters or sores that break open, sometimes with tingling or burning beforehand. Syphilis can cause a firm, usually painless sore. Genital warts, which are caused by certain types of HPV, appear as small bumps or a cauliflower-like cluster, per the CDC. Sores and bumps can also come from ingrown hairs, razor irritation or other skin conditions. A clinician can look and, when needed, test.

Itching, redness or swelling

Itching in the genital area is common with trichomoniasis, and also with yeast infections, which are not STIs. Pubic lice and scabies, which can spread through close contact, also cause itching. Because the causes differ, and treatments differ, a visit is more reliable than trying home remedies first.

Sore throat or rectal symptoms

STIs can infect the throat and rectum as well as the genitals. The CDC notes that infections at these sites often cause no symptoms. When they do, signs can include rectal pain, discharge or bleeding. If you have had oral or anal sex, ask for testing at those sites. A urine sample alone does not check them. The City of St. Louis Health Stop lists mouth and rectal swabs among its gonorrhea and chlamydia options.

Rash, fever, body aches or swollen glands

Some people notice a flu-like illness within a few weeks of HIV infection, per the CDC. Secondary syphilis can cause a rash, including on the palms and soles. These signs are general, and many things cause them. If they follow a recent possible exposure, say so when you see a clinician.

Pelvic Inflammatory Disease and Fertility

Pelvic inflammatory disease (PID) is an infection of the uterus, fallopian tubes or ovaries. The CDC says it often happens when bacteria from an untreated infection, most often chlamydia or gonorrhea, travel upward from the cervix.

What PID can feel like

Some people with PID have lower abdominal pain, pain with sex, unusual discharge, irregular bleeding, fever, or pain with urination. Others have only mild symptoms, or none. The CDC notes that PID can go unrecognized because symptoms may be subtle or absent.

The link to fertility, stated carefully

According to the CDC, PID can cause scarring in the reproductive tract. That scarring can lead to long-term pelvic pain, ectopic pregnancy (a pregnancy outside the uterus), and difficulty getting pregnant. Not everyone who has PID will have these problems. The risk is higher when treatment is delayed, and the CDC says prompt treatment lowers the chance of complications.

This is the main reason chlamydia and gonorrhea screening matters even without symptoms. Both are curable with treatment from a clinician. Finding them early gives the best chance of preventing PID.

If you already have concerns about fertility, or you have had an STI in the past, a clinician can talk through what is and is not known for your situation. A past infection does not mean you cannot have children.

When to Get an STD Test for Women

An STD test for women is not one single test. Different infections are checked with different samples. A clinician decides which to run based on your history, your partners, the kinds of sex you have, and any symptoms.

Routine screening recommendations

These recommendations come from the CDC STI Treatment Guidelines (2021) and the U.S. Preventive Services Task Force (USPSTF):

  • Chlamydia and gonorrhea: The CDC and USPSTF recommend screening for sexually active women under 25. Both also recommend screening for older women with risk factors, such as a new partner, more than one partner, or a partner who has an STI.
  • HIV: The CDC recommends that everyone from 13 to 64 be tested for HIV at least once. USPSTF recommends screening for people ages 15 to 65. More frequent testing is advised for people with ongoing risk.
  • Syphilis: USPSTF recommends screening for people at increased risk and for all pregnant women.
  • Hepatitis C: The CDC recommends hepatitis C screening at least once for adults, and during each pregnancy.
  • Cervical cancer screening: USPSTF recommends regular screening with a Pap test, an HPV test, or both, depending on age. This is how HPV-related cervical changes are found. Ask a clinician what schedule fits you.

Situations that call for testing

Beyond routine screening, many people choose to test:

  • After a new partner, or before stopping condoms with a partner
  • If a partner tells you they have an STI or have symptoms
  • After sex without a condom or after a condom broke
  • If you have any of the symptoms described above
  • At the start of a pregnancy, or when planning one
  • After sexual assault (a clinician can discuss testing and care options)

How soon after exposure?

Tests can miss an infection that is too new. The CDC says how soon a test can detect an infection varies by infection and by the type of test. Because these windows differ, a clinician may suggest testing now and again later. When you call or visit, tell them when the possible exposure happened and ask whether a repeat test is advised.

What the tests involve

For many infections, testing is simpler than people expect. Depending on the infection, the sample may be urine, a swab of the vagina, throat or rectum, a finger-prick, or a blood draw. Many clinics let you collect a vaginal swab yourself in private. The CDC notes that self-collected vaginal swabs are an accepted option for chlamydia and gonorrhea testing in women.

A note on doxy-PEP

In 2024 the CDC issued guidance on doxycycline taken after sex (doxy-PEP) to lower the chance of certain bacterial STIs. The CDC's recommendation applies to gay and bisexual men and transgender women who have had a bacterial STI in the past year. The CDC did not recommend it for cisgender women at that time because the evidence was limited. A clinician can tell you whether anything about your situation has changed and whether it applies to you. WashU Infectious Diseases lists doxy-PEP among services at its Hazelwood clinic.

When to See a Clinician the Same Day

Most STI questions can wait for a scheduled visit. A few cannot. Seek care the same day, at an urgent care, emergency department or your regular clinician, if you have:

  • Severe pain in your lower belly or pelvis, especially if it comes on suddenly
  • Fever or chills together with pelvic pain or unusual discharge
  • Nausea or vomiting with pelvic pain
  • Heavy vaginal bleeding that is not your usual period
  • Pain or swelling in the genital area that is getting worse quickly
  • Any of these symptoms while you are pregnant, or you think you might be

Severe pelvic pain can have causes other than an STI, and some are emergencies, including ectopic pregnancy. A clinician can sort that out. Going in does not mean you did anything wrong.

If you may have been exposed to HIV within the last few days, tell a clinician right away. The CDC says post-exposure prophylaxis (PEP) is a medicine prescribed by a clinician and works best when started as soon as possible after exposure. The sooner you ask, the more options you have. WashU Infectious Diseases lists PEP among services at its Hazelwood clinic, and you can call ahead to confirm.

Where to Test in St. Louis

The City of St. Louis is an independent city. The City of St. Louis Department of Health and the Saint Louis County Department of Public Health are separate agencies, and each runs its own services. You do not have to choose based on your address in every case. The county sexual health clinic says everyone is welcome regardless of where they live or their insurance status.

For a longer list with cost details, see our guide to where to get tested in St. Louis and what it costs. To search by ZIP code, the CDC runs a national testing locator at gettested.cdc.gov.

City of St. Louis Health Stop Testing and Referral Center

  • Address: 1520 Market St, Suite 1625 (first floor), St. Louis, MO 63103
  • Phone: 314-657-1584
  • Hours: Monday to Thursday, 9 a.m. to 12 p.m. and 1 p.m. to 4 p.m. Closed Fridays and city holidays, per the city.
  • Cost: The city page states, "There is no cost for this service, and no ID is necessary to receive the service."
  • Tests listed: HIV (finger-prick or blood draw), hepatitis C (finger-prick), gonorrhea and chlamydia (urine, mouth swab or rectal swab), and syphilis (blood or finger-prick). Free HIV self-test kits are also listed.
  • Timing: Rapid tests take about 15 minutes. The city says STI results take 5 to 7 business days.

The city page says walk-ins are accepted subject to availability. The CDC's GetTested listing for this site says an appointment is required. Because those two sources differ, call 314-657-1584 before you go. The city's page for the Health Stop Testing and Referral Center has the current details.

Saint Louis County Sexual Health Clinic

  • Address: 4000 Jennings Station Road, St. Louis, MO
  • Phone: 314-615-9736
  • Services: WashU Infectious Diseases, which lists the clinic, describes "STI prevention, testing, and treatment."
  • Visits: The listing says walk-in only, with no appointments.

The listing does not give hours or prices. Call before you go to confirm both.

Planned Parenthood Great Rivers, Central West End Health Center

  • Address: 4251 Forest Park Ave, Saint Louis, MO 63108
  • Phone: 314-531-7526
  • Services listed by the CDC: HIV (rapid and blood draw), herpes, chlamydia, gonorrhea and syphilis testing, HPV vaccine, and PrEP navigation.
  • Cost and visits: The CDC listing shows insurance, Medicaid and a sliding scale, and says an appointment is required. It does not list hours.

CareSTL Health, Dr. Martin Luther King Health Center

  • Address: 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112
  • Phone: 314-367-5820
  • Services listed by the CDC: HIV (blood draw), chlamydia, gonorrhea and syphilis testing, hepatitis A, hepatitis B and HPV vaccines, and PrEP navigation.
  • Cost and visits: The CDC listing shows insurance, Medicaid, Medicare and a sliding scale, and says an appointment is required. It does not list hours.

WashU Infectious Diseases, Village Square Clinic (Hazelwood)

  • Address: 1 Village Square Shopping Center, Suite 1, Hazelwood, MO 63042
  • Phone: 314-362-9098
  • Services: A May 2024 WashU news article describes a CDC-funded expansion meant to offer "walk-in testing to anyone at no or low cost," with treatment for walk-in patients and their partners. PrEP, PEP and doxy-PEP are also mentioned.

WashU described the service details as still being worked out in 2024, and no walk-in hours are listed. Call to confirm what is offered now.

Saint Louis County Department of Public Health, John C. Murphy Health Center

This center is in Berkeley, at 6121 N Hanley Rd, and its phone is 314-615-0500. The CDC listing shows hepatitis A, hepatitis B and HPV vaccines, with insurance, Medicaid and a sliding scale, and says an appointment is required. The listing does not show STI or HIV test types for this site, so ask when you call whether testing is offered.

Testing at home for HIV

The city says Health Stop provides a free HIV self-test kit (an oral fluid swab). The city page says kits can also be ordered by mail through TakeMeHome.org. TakeMeHome.org states that it offers free HIV self-test kits by mail after a short eligibility screen. The fetched page did not state the eligibility rules, so check the site. The city page does not list a free home kit for other STIs, so check with the health department if you want to know what is available.

Treatment for partners and minors

Missouri law allows expedited partner therapy for chlamydia and gonorrhea. That means a clinician may be able to prescribe treatment for a partner who has not been seen. The CDC's page on the legal status of EPT in Missouri cites Mo. Rev. Stat. 191.648.

For younger readers, Mo. Rev. Stat. 431.061 says a minor may consent for themselves to treatment in the case of venereal disease. The statute states no minimum age. It speaks of treatment, so ask the clinic how it handles testing and confidentiality for minors.

Pregnancy

Missouri law, Mo. Rev. Stat. 210.030, requires those providing obstetrical care to take a blood sample at the first prenatal visit, if the patient consents, and test it for syphilis, hepatitis B, hepatitis C and HIV. The statute describes additional draws later in pregnancy and after birth. The law has been proposed for amendment, so ask your prenatal provider what applies now.

This matters locally. The City of St. Louis health department reports 56 congenital syphilis cases in St. Louis County and the city combined from 2020 through 2022. Congenital syphilis is syphilis passed to a baby during pregnancy, and it is preventable when syphilis is found and treated in time.

What local numbers show

Rates are a reason to test, not a reason to worry. The City of St. Louis Fast-Track Cities HIV data page reports 108 new HIV diagnoses in the city in 2021, or 36.0 per 100,000 people. For St. Louis County it reports 15.0 per 100,000, and for Missouri 10.0 per 100,000. A City of St. Louis Department of Health news release from April 2022 reported that the city's gonorrhea rate rose 5% from 2019 to 2020. It also said the county's gonorrhea and syphilis rates were up 13% over the same period. The release attributed the drop in reported chlamydia in 2020 to reduced testing during the pandemic, not to fewer infections. This is why routine screening is a normal part of care here.

If you want PrEP

PrEP is a medicine a clinician prescribes to help prevent HIV. The Missouri Department of Health and Senior Services offers general PrEP information and links to the CDC's "Paying for PrEP" resource. You can reach its HIV, STI and Hepatitis program at 888-252-8045 or [email protected]. The state page does not describe a Missouri-specific PrEP payment assistance program. Planned Parenthood, CareSTL Health and WashU list PrEP navigation or PrEP services.

What Happens at a Visit and After Results

At the visit

A clinician will usually ask about symptoms, recent partners, the kinds of sex you have, and your contraception. These questions help decide which tests to run. They are not a judgment. The clinician has heard it all, and the answers stay confidential under privacy laws.

It can help to bring the date of your last period, a list of medicines you take, and the date of any possible exposure. If you are not sure what to say, it is fine to start with, "I would like a full screening, and here is why."

If a result comes back positive

The CDC says that bacterial STIs (chlamydia, gonorrhea and syphilis) and trichomoniasis are curable with treatment from a clinician. Treatment is whatever the clinician prescribes for your situation. Take it as directed and ask when it is safe to have sex again.

HIV, herpes and HPV cannot be cured, but they are treatable or manageable. People with HIV who get care can live long, healthy lives, according to the CDC. Herpes outbreaks can be managed with medicine. Many HPV infections clear on their own, and screening watches for related cervical changes.

Partners may need testing or treatment too. A clinic or the health department can help with that. If you were treated, the CDC advises retesting for some infections later, so ask when.

HIV has a legal side in Missouri. Mo. Rev. Stat. 191.677 makes it a crime to knowingly expose another person to a serious infectious or communicable disease through an activity that poses a substantial risk of transmission. It is an affirmative defense if the exposed person knew of the infection and consented. If you have questions about how this applies, a clinician or an attorney can explain it.

If a result comes back negative

A negative result means that test did not find that infection in that sample at that time. It does not cover infections you were not tested for, or exposures that happened too recently to detect. Ask the clinician which infections were checked and whether to repeat testing later.

Questions to ask

  • Which infections am I being tested for, and which am I not?
  • Do I need a throat or rectal swab as well as a urine or vaginal sample?
  • When will I get my results, and how?
  • Should I repeat any test, and when?
  • Is a vaccine, such as HPV or hepatitis B, right for me?
  • Is PrEP or anything else worth discussing?

Ways to lower your chances of getting an STI

The CDC lists several approaches: using condoms or dental dams, vaccination (HPV and hepatitis B), regular testing for you and your partners, talking openly with partners about testing, and PrEP for HIV. None of these is perfect on its own, and using more than one gives more protection.

Testing is a normal, routine part of caring for your health. Calling a clinic today is a reasonable next step, whether you have symptoms or not.

Sources