What doctors wish young adults knew about STIs

You’re an adult now. It can be uncomfortable to discuss reproductive health with others, especially your doctor, but it’s an essential part of your overall well-being. Your doctor has earned your trust and can help make these sensitive conversations easier. Take a deep breath. Your doctor is there to help you. Remember, regular screenings for sexually transmitted infections will help keep you healthy now and in the future.

From well-child checkups to soccer physicals, and immunizations to earaches— your health care provider has been there for it all. And now that you’re an adult, there may be some new items on the agenda. Pediatricians or family doctors may begin to discuss contraceptive care, reproductive health, and screenings for sexually transmitted infections (STIs) with you.

The whole time you’ve been growing up, your doctor has done what doctors do best: providing the right care at the right time. That hasn’t changed. “We’re all on the same side,” says David Bell, M.D., director of the young men’s clinic at Columbia University Medical Center in New York and president of the Society for Adolescent Health and Medicine. Doctors want to help you stay healthy and reach your fullest potential, says Dr. Bell.

 And reproductive health is a big part of that for all young adults. After all, STIs have been surging, with cases of chlamydia, gonorrhea, and syphilis increasing sharply in the past few years. More than half of all cases are among young men and women between ages 15 and 24. About 25 percent of all sexually active teen girls have an STI, including chlamydia — often without even knowing it. Also, because the environment in a young girl’s vagina isn’t completely mature, she’s more likely to develop an STI.

“Chlamydia doesn’t have any symptoms at first,” explains Michelle Rindos, M.D., an adolescent gynecologist at the University of Virginia Health System in Charlottesville. “You might not notice anything until the infection has already caused scarring in the fallopian tubes, which can lead to infertility later on.”

STIs can be dangerous for young men, too. “There is some evidence that chlamydia may affect fertility in males by causing inflammation and scarring of the epididymis, where sperm are manufactured and stored,” says Dr. Bell.

And it’s not just future fertility: STIs can lead to a variety of other serious health complications for both men and women.

The good news: STIs like chlamydia, gonorrhea, and syphilis can be cured, especially if they’re caught early. Human papillomavirus (HPV), another common STI, can be prevented with a vaccine, while herpes can be treated and stopped from spreading. That’s why the Centers for Disease Control and Prevention (CDC) recommends routine STI screenings for young people who are sexually active.

So, when your doctor asks you about your sexual activity, don’t be surprised — and don’t be offended. “The doctor’s role is to be able to talk with [you] about all aspects of [your] health,” says Dr. Bell.

Here’s what you can expect during an office visit:

Expect an STI screening

Through a face-to-face conversation or a questionnaire, the doctor will try to get a sense of what’s going on in your life. If you’re sexually active, screening is recommended — and easy. One simple urine test can determine the presence of both chlamydia and gonorrhea. Here are the CDC screening guidelines recommended for annual testing:

Chlamydia

• All sexually active girls
• All sexually active boys in areas with high chlamydia rates
• Boys 13 and older who have same-sex relations            

Gonorrhea

• All sexually active girls
• Boys 13 and older who have same-sex relations

Syphilis

• Boys over age 13 who have same-sex relations

HIV

• Boys over age 13 who have same-sex relations
• Any boy or girl who injects drugs
• Any boy or girl whose partner has HIV

Expect contraceptive care

An unwanted pregnancy can throw a young woman’s life and future plans off kilter, so talking about contraception with your doctor is critical.

“We always have a conversation about birth control,” says Dr. Rindos. “I find that teens at this age might not be as responsible about taking a pill every day, so we tend to do long-acting reversible contraception, or LARC. There are implantable devices and long-term shots to prevent pregnancy.”

Dr. Bell discusses contraception with his male patients, too. For young men, he explains, “the option is mainly condoms, so we talk about using them correctly. And we also encourage young men to be supportive toward their female partner. It’s important for them to think about dual protection, too, even if their partner is on birth control. After all, condoms protect against STDs but female birth control doesn’t.”