Sexually transmitted diseases or infections (STDs/STIs) are staggeringly common, with over a million acquired every single day by people the world over, according to data from the WHO. Many men and women with these STDs have no symptoms at all. However, as the WHO warns, these infections could cause long-term damage. Even an STD someone contracts in their 20s could linger on, hampering fertility in later life.1
When Do STDs Cause Fertility Problems?
When unprotected sexual intercourse between a couple for more than 12 months (with monthly intercourse) fails to result in conception/pregnancy, it is labeled infertility. Overall, about 40 percent of infertility cases have a male factor, 40 percent a female factor, and 20 percent have both.2 A higher prevalence of infertility in less industrialized nations has also been linked to higher prevalence of infectious STDs, which typically result in fertility issues when they are untreated.
The Double STD Whammy In Your Twenties
Of all STDs, two in particular are more common in your twenties.
Chlamydia is the most frequently reported STD in the country. This bacterial infection is most common in men and women who are 24 years or younger. Among women, it is also a cause of PID, infertility, and ectopic pregnancy. Unfortunately, because it can be asymptomatic in both men and women, it may go undiagnosed.3
Repeat in or other fertility issues in women. After one instance of chlamydia, preventive measures and screening tests 3 months after the treatment concludes are vital.4
Gonorrhea is a common STD that affects the genitals as well as rectum and throat. It is especially prevalent among the age group in their late teens and twenties. It can be transmitted via vaginal as well as oral and anal sex.
Left untreated it can result in sterility in men and prevent them from being able to father children. In women it could cause PID, which in turn causes problems like blocked fallopian tubes (resulting from scar tissue), infertility, and ectopic pregnancy. 5
STDs And Fertility In Women
According to the WHO, about 131 million new cases of chlamydia and 78 million new cases of gonorrhea are recorded every year. These STDs are key causes of pelvic inflammatory disease (PID), with about 10 to 20 percent of cases of these two resulting in PID.6 Blocked fallopian tubes in women, also called tubal occlusion, another cause of fertility issues, can result from a history of chlamydia and gonorrhea.7
The CDC links about 24,000 cases of infertility in women each year to these infections.8
Male-Factor Infertility And STDs
Gonorrhea can also bring on sterility in men. In general, STDs can damage sperm structure and motility, and modify the composition of seminal fluid. Spermatogenesis can also be impaired by infection. The ejaculatory duct may sometimes be blocked due to inflammation resulting from these STDs. One study found that sperm motility was lowered in the presence of bacteria, as is common from STDs.9
If untreated, these could persist in the system and may hamper fertility in later life.
HIV And Lower Fertility
A study in Sub-Saharan Africa found that fertility was below normal for people in Zimbabwe, with “HIV associated subfertility” responsible for about 25 percent of the decline the country has seen in two decades since the 80s. Among causative factors were pelvic inflammatory disease, higher incidence of amenorrhea, lowered frequency of coitus, as well as social factors like divorce.10 Certain STDs like syphilis and herpes simplex virus (HSV) type 2 predispose you to higher chances of getting HIV. According to the WHO, over 500 million people have HSV.11
Precautions To Lower Risks From STDs
Timely intervention through the right diagnosis and medication/treatment can usually help circumvent some of the fertility fallout. The good news is, if contracted, these bacterial infections can be cured using single-dose antibiotics. However, of late, drug resistance, a major issue for gonorrhea treatment, is threatening the efficacy of these treatments.12
Your first line of defense is to use contraception, specifically condoms, to protect against contracting an STD. In addition, regular screenings are important for anyone who is sexually active and/or has multiple partners. This becomes crucial in your twenties when you may not have a single partner, or when you or your partner are more active. The CDC recommends routine annual screening for chlamydia as well as gonorrhea for all sexually active women who are under 25 years. In fact, there is evidence of chlamydia screening actually bringing down PID rates in women. Men too should be screened for infection, as they can be carriers and contribute to the problem.13
|↑1||Sexually transmitted infections (STIs). Fact sheet N°110. December 2015,WHO.|
|↑2||Cannon, Emma. “How to Optimise and Preserve Fertility: Current Research, Lifestyle Choices and Chinese Medicine.”|
|↑3, ↑13||Chlamydial Infections in Adolescents and Adults, Centers for Disease Control and Prevention.|
|↑4||Chlamydial Infections in Adolescents and Adults, Centers for Disease Control and Prevention.|
|↑5||Gonorrhea – CDC Fact Sheet, Centers for Disease Control and Prevention.|
|↑6||What is the link between sexually transmitted diseases or sexually transmitted infections (STDs/STIs) and infertility? National Institute of Health.|
|↑7||Infertility FAQs, Centers for Disease Control and Prevention.|
|↑8||Sexually Transmitted Diseases in the United States, 2008, Centers for Disease Control and Prevention.|
|↑9||Sabra, S. M., and Mohamed Salem Al-Harbi. “An influential relationship of seminal fluid microbial infections and infertility, Taif Region, KSA.” World J Med Sci 10 (2014): 32-7.|
|↑10||Terceira, Nicola, Simon Gregson, Basia Zaba, and Peter Mason. “The contribution of HIV to fertility decline in rural Zimbabwe, 1985-2000.” Population studies 57, no. 2 (2003): 149-164.|
|↑11, ↑12||Sexually transmitted infections (STIs). Fact sheet N°110. December 2015, WHO.|