Sexually transmitted infections (STIs) can remain untreated for varying periods, with consequences differing significantly based on the specific infection. Even without obvious symptoms, these infections can cause substantial internal damage over time. This article explores the various outcomes of untreated STIs.
Understanding Untreated Sexually Transmitted Infections
Untreated sexually transmitted infections can quietly progress within the body, often without immediate or noticeable symptoms. This asymptomatic period can last for varying lengths of time, during which the infection continues to cause internal damage. Many individuals may be unaware they carry an STI, making it easier to unknowingly transmit the infection to others.
The absence of symptoms does not mean the infection is harmless; rather, the underlying infection persists and can worsen. The duration an STI can go untreated before causing significant harm is not a single, fixed period, as it depends on the specific type of bacteria or virus involved, the individual’s immune system, and other health factors.
The Progression of Specific Untreated STIs
Untreated sexually transmitted infections can lead to a range of severe health problems, with progression and severity differing for each type of infection.
Chlamydia and gonorrhea are bacterial STIs that can cause serious complications if not treated. In women, untreated chlamydia can spread to the uterus and fallopian tubes, leading to pelvic inflammatory disease (PID) within weeks to months. Untreated gonorrhea can similarly cause PID, which may result in chronic pelvic pain, scarring of the fallopian tubes, and abscess formation. For men, untreated gonorrhea can lead to epididymitis, an inflammation of the coiled tube behind the testicles that stores sperm, potentially causing pain, swelling, and infertility. Chlamydia can also lead to epididymitis in men.
Syphilis progresses through distinct stages if left untreated. The primary stage involves a painless sore (chancre) appearing 10 to 90 days after exposure, which heals on its own within 3 to 10 weeks. Without treatment, the infection moves to the secondary stage, usually within 2 to 8 weeks after the chancre disappears, characterized by a rash and flu-like symptoms. If still untreated, syphilis enters a latent stage, which can last for years or even decades without visible symptoms. The infection can then progress to tertiary syphilis, which may develop 10 to 30 years after the initial infection, causing severe damage to the heart, brain, nerves, and other organs.
Herpes Simplex Virus (HSV) infections, while often causing recurrent outbreaks of painful sores, remain in the body for life once acquired. The virus can reactivate periodically, leading to new outbreaks. Although direct progression to severe organ damage is uncommon in otherwise healthy individuals, the virus can cause severe complications like meningoencephalitis in people with weakened immune systems.
Human Immunodeficiency Virus (HIV) infection progresses through stages if left untreated, typically over years. The acute stage, often accompanied by flu-like symptoms, occurs within 2 to 4 weeks of infection. This is followed by a chronic or clinical latency stage, where the virus continues to multiply at low levels, often without symptoms, for 10 years or more. Without treatment, HIV can progress to acquired immunodeficiency syndrome (AIDS), the final stage, where the immune system is severely compromised, making the individual susceptible to life-threatening opportunistic infections.
Human Papillomavirus (HPV) infection, particularly with high-risk types, can persist for many years and lead to the development of certain cancers if untreated. While most HPV infections clear on their own, persistent high-risk HPV can cause cellular changes that slowly progress to cancer over 10 to 20 years, or even longer. These cancers can include cervical, anal, and some oral cancers.
Reproductive Health and Pregnancy Complications
Untreated sexually transmitted infections can profoundly impact reproductive health and lead to severe complications during pregnancy and for newborns. These effects often result in long-term or irreversible damage.
Untreated chlamydia and gonorrhea are significant causes of infertility. In women, these infections can ascend into the reproductive tract, causing pelvic inflammatory disease (PID), which leads to scarring and blockage of the fallopian tubes, preventing successful conception. PID also increases the risk of ectopic pregnancy, a life-threatening condition where a fertilized egg implants outside the uterus. In men, untreated gonorrhea can lead to epididymitis, causing inflammation and scarring that can obstruct sperm flow and result in infertility.
For pregnant individuals, untreated STIs pose serious risks to both the parent and the developing fetus. Untreated syphilis during pregnancy can lead to miscarriage, stillbirth, premature birth, or congenital syphilis in the newborn, causing severe health problems like bone deformities, anemia, and neurological issues. Untreated HIV can be transmitted from a parent to their child during pregnancy, childbirth, or breastfeeding. Herpes simplex virus (HSV) can be passed to a newborn during delivery, causing neonatal herpes, which is rare but can be life-threatening. Untreated chlamydia and gonorrhea in pregnant individuals can also result in premature delivery and severe eye infections or pneumonia in the newborn.
The Urgency of Testing and Treatment
Given the potential for severe and often silent progression of sexually transmitted infections, prompt testing and appropriate treatment are important. Early detection through regular STI screening allows for timely intervention, which can effectively prevent most of the long-term health complications discussed. Many bacterial STIs, such as chlamydia, gonorrhea, and syphilis, are curable with antibiotics, especially when treated in their early stages.
Even for viral STIs like HIV and herpes, which are not curable, effective treatments are available. These treatments manage the infection, suppress symptoms, prevent progression to more severe disease, and reduce the risk of transmission to others. Open communication with healthcare providers and sexual partners is important, as is adherence to recommended treatment plans. Taking timely action can protect individual health and contribute to broader public health efforts by reducing STI prevalence and associated complications.