By Kerry-Ann Kelly, M.D., M.P.H., Board Certified Obstetrician and Gynecologist; Medical Director of Innovation & Health Equity, Simple HealthKit
Infertility Awareness Week is April 23-29, 2023 – its purpose is to enhance public understanding that infertility needs and deserves attention. As a physician specializing in women’s reproductive health, I work with patients experiencing infertility every day, and many of them are surprised to hear that one of the most commonly known causes of infertility is Sexually Transmitted infections (STIs) such as chlamydia and gonorrhea.
1 in 2 sexually active people will contract an STI by age 25, and many are asymptomatic and unaware. This can lead to dire consequences: 10-15% of women with untreated chlamydia, for instance, will develop Pelvic Inflammatory Disease (PID), a leading cause of infertility. Gonorrhea can cause scarring in fallopian tubes that could result in ectopic pregnancy or make it impossible to conceive naturally.
There are disparities in the rates of reported STDs. In 2020, nearly a third of all cases of chlamydia, gonorrhea, and syphilis cases were among non-Hispanic black persons – even though they make up only 12 percent of the US population. These differences are likely not related to sexual behavior but access to quality sexual health care.
The good news
The good news is that STIs are generally very treatable if diagnosed quickly. It’s only when these silent infections are left undiagnosed and untreated for years that STIs progress to the point where they can cause permanent damage that leads to infertility.
What you can do about it
I advise patients to get tested for STIs annually – it can be done at your doctor’s office, or you can buy an at-home sexual wellness test kit. Even patients in monogamous relationships should consider testing annually as unnecessary as that seems. Even if your physician says it’s not necessary, you need to do it if you believe you have had sexual contact that puts you at risk of contracting an infection.
If you’re in a non-monogamous relationship, you should be tested more regularly, especially if you feel you’ve been exposed. Barrier protection such as condoms are helpful, and you should definitely use them, but they don’t always prevent STIs – they can break, burst, or fall off.
If you’re having trouble conceiving, STIs should be one of the first things a physician tests for. They’ll also look at your medical history, age, family history, genetics, and chronic conditions. They should do all of this for you and your partner – infertility doesn’t just happen to women. If your physician doesn’t suggest STI testing, you should ask for it or buy an at-home test kit and then share the results with your physician. If you don’t test, you don’t know.
Bacterial STIs are extremely common. There’s no shame in making this conversation an annual one with your healthcare provider. Taking control of your health and being proactive about STI testing can make all the difference when you decide you want to conceive.
What your organization can do
Many retailers, pharmacies, health centers, and public health departments have begun offering affordable and accessible STD/ STI testing to the communities they serve. Simple HealthKit can provide a complete diagnostic testing solution for your organization – it even includes follow-up care. Reach out to a Simple HealthKit team member to learn more.