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STD Testing: How Do Doctors Test Women for STDs?

Sexually transmitted infections (STIs) or diseases (STDs) are more common than you might think. And while most are completely treatable, it’s important to treat them promptly as some can lead to more severe health issues including infertility, blindness, cancer, and organ damage.
A doctor consulting her patient about STD testing

Unfortunately, the stigma surrounding STDs means that too many people don’t get prompt testing and the appropriate treatment. In fact, sometimes it even discourages people from getting tested at all. 

STD testing is something that you’ll need to speak to your doctor about. Read on to learn more about it, including when you should go, what tests are available, and how the tests work.

When is STD testing necessary?

If you’re sexually active, it’s good to get STD testing on a regular basis. It’s particularly important to talk to your doctor about STD testing if:

  • You are beginning a new relationship
  • You and your partner are considering having sex without condoms
  • Your partner has multiple sexual partners or has cheated on you
  • You are having sex with multiple partners
  • You are experiencing symptoms and signs that suggest you may have a sexually transmitted infection 

If you’re in a mutually monogamous, long-term relationship and both you and your partner were tested for STDs before entering the relationship, then you may not require regular STD testing. 

But the reality is that most people don’t get STD testing before they enter relationships, long term or otherwise. If you fall into this group, it’s a good idea to consider STD testing to rule out the possibility that you’re carrying an undiagnosed STD that isn’t producing symptoms.

While your annual gynecological examination is a great time to do STD testing, don’t presume that your physician will automatically do it. Be sure to specifically ask for the tests you need or want.  Women who are pregnant will receive STD testing as a screening procedure during the initial prenatal visit, as some infections can affect the fetus. 

Below we’ve compiled guidelines for some of the most common STD tests:

Gonorrhea and chlamydia

Symptoms of gonorrhea include vaginal discharge, vaginal bleeding between periods, and pain while urinating. Chlamydia symptoms are similar, including vaginal discharge, abdominal pain, and pain while urinating. If you’re experiencing these symptoms, it’s a good idea to ask your doctor for an STD test.

  • You should get an annual screening for these infections if:
  • You’re a sexually active female younger than 25 years of age
  • You’re a female older than 25 years of age and are at risk of getting STIs; for instance, you have multiple sexual partners or a new partner
  • You were sexually assaulted and are concerned that you may have contracted an STI
HIV test

According to the Centers for Disease Control and Prevention (CDC), women between the ages of 13 and 64 should get HIV testing at least once as part of routine medical care. The CDC recommends annual HIV testing if your risk of getting STIs is high. 

Hepatitis C screening is advised for everyone born between 1945 and 1965, as this demographic tends to see a higher incidence of hepatitis C. 

You should get tested for syphilis, hepatitis, and HIV if:

  • You’ve had multiple sexual partners (or your partner has had sex with multiple partners) since you last had STD testing
  • Your test for another STI is positive
  • You use intravenous drugs
  • You are pregnant or planning to become pregnant
  • You were sexually assaulted and are concerned that you may have contracted an STI

Human papillomavirus (HPV)

HPV is one of the most common infections among sexually active people. While it’s about three times more common in men than women, certain types of HPV can lead to genital warts or cervical cancer — so it’s important for women to be tested. Testing for HPV involves:

  • Pap test: Pap test checks the cervix for the presence of abnormal cells. Women between the ages of 21 and 65 should get a Pap test every three years. 
  • HPV test: Women over the age of 30 are recommended to have an HPV test every five years, if their previous pap tests were normal. Women between the ages of 21 and 30 years are offered an HPV test if their pap test was not normal.

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How to get tested for STDs

How do doctors test for STDs in women? Your doctor will order the necessary tests, depending on your sexual history, to check for STDs. The tests may include urine tests, blood tests, physical exams, and swabs. 

Urine and blood tests

How do doctors test for STDs using your blood and urine? Just like the blood and urine samples you probably provide during your yearly check-up, doctors need just a small sample to analyze in the lab. Blood and/or urine tests are common for the following STIs:

  • Chlamydia
  • Hepatitis
  • Gonorrhea
  • HIV
  • Syphilis
  • Herpes

In certain cases, blood and urine tests may not provide accurate results. Furthermore, blood tests may only become reliable about a month after exposure to the STI. For instance, HIV takes anywhere from several weeks to a couple of months to show up in a blood test. Tests conducted earlier than this may come back (falsely) negative for HIV.

Swabs

Many physicians use urethral, cervical, or vaginal swabs for STD testing. In females, they may take cervical and vaginal swabs using a cotton applicator during a pelvic examination. In both males and females, they insert a cotton applicator into the urethra to take urethral swabs. 

HPV testing and Pap smears

a Pap test

A Pap smear is a type of test that looks for the presence of abnormal cells in the cervix, which may indicate early cervical cancer. Women who have recurrent HPV infections are more prone to developing cervical cancer. A normal Pap smear doesn’t indicate whether you have the STD or not; to check, your physician has to order an HPV test. 

Physical examination

Your doctor may diagnose certain STDs, such as genital warts and herpes, using a combination of a physical exam and other tests. They may perform a physical examination to look for bumps, sores, and other signs of STDs. They may also take tissue samples from these areas and send them to a lab for STD testing. 

So what’s the bottom line? If you’re sexually active, it’s good to get STD testing. It’s especially important if you are beginning a new relationship, if you or your partner has multiple sexual partners, or if you’re experiencing symptoms that suggest you may have an STI. Your doctor will take a sexual history and then order the necessary tests, which may include urine or blood tests, swabs, and physical exams. 

https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/in-depth/std-testing/art-20046019

https://www.healthline.com/health/sexually-transmitted-diseases/getting-tested

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