This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

Many sexually transmitted infections (STIs) cause no symptoms at all. Others cause signs that look a lot like a yeast infection, a urinary tract infection or a normal change in your cycle. That is why symptoms alone are a poor guide, and why testing is the only way to know what is going on.

This guide explains the symptoms of STDs in females, the signs that are worth a visit, how untreated infections can affect the pelvic organs and fertility, and what an STD test for women usually involves. It also lists free and low-cost places to get tested in Boston.

The language here is for everyone with a cervix, vagina or vulva, including cisgender women, transgender men and nonbinary people. Where a recommendation applies to a specific group, the text says so.

Key takeaways

The Centers for Disease Control and Prevention (CDC) says most women with chlamydia have no symptoms, and many other STIs are also silent.
Unusual discharge, pain with sex, burning when you urinate, sores, bleeding between periods or pelvic pain are all good reasons to see a clinician. None of them points to one specific infection.
Untreated chlamydia and gonorrhea can lead to pelvic inflammatory disease (PID), which can affect fertility. Bacterial STIs are curable with treatment from a clinician.
Severe pelvic or lower belly pain, fever with pelvic pain, or pain during pregnancy deserves same-day medical care.
The U.S. Preventive Services Task Force (USPSTF) recommends chlamydia and gonorrhea screening for sexually active women 24 and younger, and for older women at increased risk.
Boston has several free or sliding-scale testing sites, listed below. Massachusetts law lets a minor who reasonably believes they are at risk consent to STI care without a parent.

Why symptoms are an unreliable guide
Symptoms of STDs in females, infection by infection
Signs that are worth a test
Pelvic inflammatory disease and fertility
When to be seen the same day
What an STD test for women involves and who should have one
Where to test in Boston
Privacy, minors, partners and what happens after a result

Why symptoms are an unreliable guide

It is natural to look for signs of trouble in your own body. With STIs, that approach often fails, for three reasons.

Many infections are silent

The CDC says chlamydia is often called a "silent" infection because most people who have it do not notice symptoms. The CDC also reports that about 70 percent of people with trichomoniasis have no signs or symptoms. Gonorrhea in women is often mild or mistaken for another condition. HIV can cause no symptoms for years. Genital herpes and HPV (human papillomavirus) are frequently silent too.

Symptoms overlap with common conditions

Vaginal discharge, itching and burning are also caused by yeast infections and bacterial vaginosis, which are not STIs. Burning when you urinate can come from a urinary tract infection. Spotting can come from hormones, birth control or a cervical change. A clinician can sort these out with an exam and lab tests. Guessing at home often leads to the wrong treatment.

Symptoms can come and go

Some signs appear soon after exposure and fade without treatment, even though the infection is still there. A syphilis sore, for example, can heal on its own while the infection continues. A symptom that goes away is not proof that an infection has gone away.

The practical takeaway is simple. If you are sexually active, testing on a regular schedule is more dependable than watching for symptoms. Symptoms are a reason to be tested sooner, not a requirement for being tested.

Symptoms of STDs in females, infection by infection

The lists below describe what the CDC says people may notice with each infection. A symptom on this list does not mean you have that infection, and having no symptoms does not mean you do not. Only a test can tell.

Chlamydia

When symptoms occur, the CDC lists an abnormal vaginal discharge and a burning sensation when urinating. Some people have pain during sex, bleeding between periods or lower abdominal pain. Chlamydia can also infect the rectum or throat, depending on the type of sex a person has. Chlamydia is curable with treatment from a clinician.

Gonorrhea

The CDC says gonorrhea in women can cause increased discharge, burning with urination, bleeding between periods, or no symptoms at all. Because the signs are mild, they are easily mistaken for a bladder or vaginal infection. Gonorrhea is curable with treatment from a clinician.

Trichomoniasis

The CDC describes itching, burning, redness or soreness of the genitals, discomfort with urination, and a change in vaginal discharge. The discharge may be clear, white, yellowish or greenish, and may have an unusual smell. Trichomoniasis is curable with treatment from a clinician.

Syphilis

The CDC describes syphilis in stages. The first sign is usually a sore, called a chancre, which is often firm, round and painless. In women it can appear inside the vagina or on the cervix, where it may go unnoticed. Later stages can bring a rash, often on the palms and soles, along with fever, swollen lymph glands, sore throat or patchy hair loss. Syphilis is curable with treatment from a clinician, and it is more easily treated the earlier it is found.

Genital herpes

The CDC says most people with genital herpes have no symptoms or very mild ones. When signs do appear, they can include blisters or sores on or near the genitals, rectum or mouth, sometimes with pain, itching, flu-like symptoms or swollen glands. Outbreaks can recur. Herpes is not curable, but it is treatable, and clinicians can prescribe medicine that shortens or reduces outbreaks.

HPV and genital warts

The CDC says most HPV infections cause no symptoms and clear on their own. Some types cause genital warts, which are small bumps or clusters of bumps in the genital area. Other types can cause cell changes on the cervix, which is why cervical screening matters. HPV itself is not curable, but the health problems it can cause are treatable, and a vaccine is available.

HIV

The CDC says some people have a flu-like illness within two to four weeks of HIV infection, with fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes or mouth ulcers. Others have no symptoms at all. The only way to know is to test. HIV is not curable, but it is treatable, and the CDC says people with HIV who take treatment as prescribed and keep an undetectable viral load cannot sexually transmit the virus to others.

Hepatitis B and hepatitis C

Both are viral infections of the liver and can be sexually transmitted. Many people have no symptoms for a long time. When symptoms appear they can include tiredness, nausea, belly discomfort, dark urine or yellowing of the skin and eyes. The CDC recommends that all adults 18 and older be screened for hepatitis C at least once, and that pregnant people be screened during each pregnancy.

Signs that are worth a test

Any of the following is a reasonable reason to contact a clinic. Several of them also have non-STI causes, which is exactly why a clinician and a lab test are useful.

Changes in discharge or odor

Discharge that is new, increased, or different in color or consistency
A new or strong odor
Itching, redness or irritation of the vulva or vagina

Pain or burning

Burning or pain when you urinate
Pain during vaginal, anal or oral sex
Lower belly or pelvic pain that is new or does not go away
Rectal pain, discharge or bleeding
Sore throat after oral sex that does not improve

Bleeding

Bleeding between periods
Bleeding after sex
Periods that become noticeably heavier or more painful without a clear reason

Skin changes

A sore, blister, bump or ulcer anywhere on the genitals, anus or mouth, painful or not
A rash, especially on the palms or soles
Warts or clusters of small bumps

General symptoms

Fever, chills, night sweats or swollen glands that you cannot explain
Unusual fatigue together with any of the signs above

Situations that are reasons to test even with no symptoms

A new partner, or more than one partner
A partner who tells you they have an STI, or who has symptoms
Sex without a condom or other barrier with a partner whose status you do not know
A previous STI
Pregnancy, or planning a pregnancy
A routine check that has not happened in the past year

Pelvic inflammatory disease and fertility

Pelvic inflammatory disease (PID) is an infection of the reproductive organs: the uterus, fallopian tubes and ovaries. The CDC says PID most often happens when bacteria, including those that cause chlamydia and gonorrhea, spread upward from the vagina and cervix. Not all PID comes from an STI, but untreated chlamydia and gonorrhea are important causes.

What PID can feel like

The CDC says some people with PID have mild symptoms or none. When symptoms occur, they can include pain in the lower abdomen or pelvis, unusual discharge, bleeding between periods or after sex, fever, pain during sex and pain when urinating. Because the signs can be subtle, PID is sometimes not recognized until complications develop.

How PID can affect fertility

The CDC says PID can cause scarring in the fallopian tubes. That scarring can lead to long-term pelvic pain, ectopic pregnancy (a pregnancy that develops outside the uterus), and difficulty becoming pregnant. The CDC notes that treatment can stop PID from getting worse, but it cannot reverse scarring that has already happened. That is why finding and treating infections early matters.

What this does and does not mean

Having had an STI does not mean you will develop PID or have trouble getting pregnant. Many people treated for chlamydia or gonorrhea have no lasting effects. The point is that testing and treatment lower the chance of complications. If you are worried about fertility, a clinician can talk through your own situation.

Treatment for PID

PID is treated with antibiotics prescribed by a clinician. Sexual partners are usually evaluated and treated as well, so the infection does not pass back and forth. Your clinician will explain the plan that fits your situation.

When to be seen the same day

Most STI concerns can be handled with a routine or express appointment. A few situations call for faster care. If you have any of these, contact a clinician, urgent care or an emergency department the same day.

Severe pain in the lower belly or pelvis, especially if it began suddenly
Fever or chills together with pelvic pain, unusual discharge or pain with sex
Vomiting with pelvic or belly pain
Heavy vaginal bleeding, or dizziness or fainting with pelvic pain
Pelvic pain or bleeding when you are pregnant or could be pregnant
Pain or swelling in the genital area that is increasing quickly
Eye pain or vision changes with a known or possible genital infection

If your symptoms feel severe or frightening, call 911 or go to the nearest emergency department. You do not need to decide in advance what is causing the problem. Describe what you feel, and the care team will take it from there.

If you have had a recent exposure and are worried about HIV, ask a clinician about post-exposure prophylaxis (PEP). The CDC says PEP is a prescription medicine that must be started as soon as possible after a possible exposure, and within 72 hours at most. Several Boston clinics listed below list PEP among their services.

What an STD test for women involves and who should have one

What the visit usually looks like

A clinician will ask about your symptoms, your recent partners and the kinds of sex you have. These questions are routine and are asked without judgment. Answering honestly helps them choose the right tests, because infections can live in the genitals, rectum or throat.

Depending on what you describe, testing may include:

A urine sample or a swab of the vagina, which you can often collect yourself, for chlamydia and gonorrhea. Swabs of the throat or rectum may be added.
A blood test for HIV, syphilis and, when recommended, hepatitis B or C
A swab or other test for trichomoniasis
A swab of a sore or blister if one is present, to test for herpes
A pelvic exam if you have pain, discharge or bleeding

A routine Pap test or cervical screening is a different test. It looks for cervical cell changes and does not check for most STIs. If you are not sure what was included in a past visit, ask the clinician.

Who should be tested, and how often

The USPSTF recommends screening for chlamydia and gonorrhea in sexually active women 24 years and younger, and in older women who are at increased risk. The CDC STI Treatment Guidelines (2021) are consistent with this and also recommend more frequent screening for people with new or multiple partners, or a partner with an STI. The CDC also recommends that everyone from 13 to 64 be tested for HIV at least once, and more often with ongoing risk.

The CDC recommends syphilis screening for all pregnant people at the first prenatal visit. It recommends repeat testing at later points in pregnancy for people at higher risk. Ask your prenatal clinician what applies to you.

For cervical cancer screening, the USPSTF recommends screening every three years with cervical cytology for people 21 to 29. For those 30 to 65, options include cytology every three years, HPV testing every five years, or both together every five years.

Timing and window periods

Tests look for either the germ itself or the body's response to it, so timing matters. The CDC gives these ranges for HIV after an exposure: a nucleic acid test can usually detect HIV 10 to 33 days after exposure, an antigen and antibody test done on blood from a vein usually 18 to 45 days, and rapid antigen and antibody tests done on a finger stick usually 18 to 90 days. Antibody tests can take 23 to 90 days.

For other infections, ask the clinician when to test and whether to repeat a test later. If you are unsure after a recent exposure, tell the clinic when it happened and they will advise you.

Results and treatment

Fenway Health's clinic page says results take 3 to 5 business days. Other sites vary, so ask when you check in. If a test is positive for a bacterial STI or trichomoniasis, a clinician can prescribe treatment that cures it. For HIV and herpes, a clinician can prescribe treatment that manages the infection. Your clinician decides which medicine fits you, and will tell you how long to avoid sex while treatment works.

A note on doxy-PEP

In 2024 the CDC issued guidance on doxycycline taken after sex (doxy-PEP) to lower the chance of certain bacterial STIs. The CDC recommends considering it for gay, bisexual and other men who have sex with men, and transgender women, who have had a bacterial STI in the past 12 months. It is not a general recommendation for other groups. Fenway Health lists doxy-PEP among its services. A clinician can tell you whether it is appropriate for you.

Where to test in Boston

Boston has free and sliding-scale testing across several neighborhoods. The City of Boston publishes information on getting tested for STIs, and the Boston Public Health Commission (BPHC) runs the city's infectious disease programs. For a fuller walkthrough of options and costs, see our guide to STD testing in Boston, where to get tested and what it costs.

Hours and services change. Call before you go, particularly if you need a specific test.

Boston STD Clinic at Boston Medical Center

Address: 725 Albany St., 9th Floor, Suite 9C (BMC Shapiro Center), Boston, MA 02118. Phone: 617-414-2803. The clinic's page says routine testing for HIV, chlamydia, gonorrhea, syphilis and hepatitis C is free, with cost assistance for people without insurance. It also lists PrEP and PEP. Appointments are made by phone or MyChart for established patients. The page lists weekday hours, but it is inconsistent about Tuesday, so confirm by phone. It does not say whether walk-ins are accepted. Boston STD Clinic page.

Fenway Health Sexual Health Clinic

Address: Ansin Building, 1340 Boylston Street, 4th floor, Boston, MA 02215. Phone: 617-267-0159, with a main line at 617-267-0900. Fenway's page lists walk-in hours, first come first served: Tuesday 1 to 7 p.m., Wednesday and Thursday 3 to 7 p.m., and Friday 9 a.m. to noon. Monday 9 a.m. to 4 p.m. is by appointment only. Check-in closes 30 minutes before the end time. The page says Fenway bills insurance if you have it, and that people without insurance can be seen free through grant funding. Fenway's page is aimed at gay, bisexual and other men who have sex with men, transgender and gender diverse people, and their partners, so call to ask whether the clinic is the right fit for you. Fenway Health STD testing page.

X-Clinic at Codman Square Health Center

Address: 637 Washington St., Dorchester, MA 02124. Phone: 617-822-8350. Codman's page lists express walk-in visits for people with no symptoms and no known exposure, plus appointments and telehealth. It accepts all insurance, uses a sliding fee schedule, and says it provides testing and treatment regardless of citizenship status. Teen testing is confidential. Codman's two pages list different hours, so call to confirm. Coverage help is at 617-822-8162. X-Clinic page.

TrueCare@MAC testing at the Multicultural AIDS Coalition

Address: 9 Palmer Street, Roxbury, MA 02119. Phone: 617-442-1622. The clinic's page lists free STD, HIV and hepatitis C testing, with or without an appointment. Listed testing hours are Monday, Tuesday, Thursday and Friday 10:30 a.m. to 4 p.m., Wednesday 12:30 to 6 p.m., and Saturday 11:30 a.m. to 3 p.m. Sunday is not listed. Multicultural AIDS Coalition.

Boston Public Health Commission

The CDC's GetTested directory lists BPHC at 774 Albany St, Boston, MA 02118, phone 617-534-3976, with free HIV, hepatitis C, chlamydia, gonorrhea and syphilis testing. The directory does not list hours and says they may change, so call before you go. This is a different provider from Boston Medical Center, even though both are on Albany Street. CDC GetTested listing.

Planned Parenthood League of Massachusetts, Greater Boston Health Center

The CDC's GetTested directory lists this center at 1055 Commonwealth Ave, Boston, MA 02215, phone 617-295-7235. It lists STD and HIV testing, rapid HIV testing, hepatitis C testing, PrEP navigation and HPV vaccine. An appointment is required. It accepts insurance, Medicaid and Medicare, and offers a sliding scale. Hours are not listed there. CDC GetTested listing.

DotHouse Health

The CDC's GetTested directory lists DotHouse Health at 1353 Dorchester Avenue, Dorchester, MA 02122, phone 617-288-3230. It lists STD, HIV and hepatitis C testing, PrEP navigation, HPV vaccine, Medicaid, Medicare and sliding-scale fees, with services in English, Portuguese and Spanish. The directory lists appointments as required, while another local resource list mentions walk-in testing through urgent care at the same phone number, so ask which applies. CDC GetTested listing.

Other ways to find a site

The Mayor's Health Line, 617-534-5050, offers free, confidential, multilingual health information and referral, according to the City of Boston. You can also call the BPHC Infectious Disease Bureau at 617-534-5395. To look up more sites by address, use the CDC's directory at gettested.cdc.gov. The City of Boston's page is at boston.gov/getting-tested.

How common are STIs in the Boston area?

According to CDC county data republished by Boston 25 News in March 2024, Suffolk County, which contains Boston, had a 2021 chlamydia rate of 807.8 per 100,000 people (6,230 cases), the highest in Massachusetts. The gonorrhea rate was 298.0 per 100,000 (2,298 cases). These are county figures, not city-only numbers, and they come from a news report rather than from the health department itself. For current local numbers, check with the Boston Public Health Commission or the Massachusetts Department of Public Health.

These figures only show that STIs are a common part of community health. They say nothing about any one person.

Privacy, minors, partners and what happens after a result

Minors and consent

Massachusetts General Laws chapter 112, section 12F says a minor who reasonably believes they are at risk of exposure through sexual activity may consent to care to diagnose or treat the disease, or to HIV prevention if sexually active, without a parent's consent. The law's confidentiality rules say records are kept between the minor and the clinician. The exception is that the provider must notify a parent or guardian if the minor's life or limb is seriously endangered. The City of Boston tells people 13 or older that they can get a confidential STI test without parental permission. Codman's page also describes teen testing as confidential.

Reporting and confidentiality

Massachusetts General Laws chapter 111, section 111 provides for reporting of venereal diseases to local boards of health under Department of Public Health rules. Section 119 makes those reports and records non-public, with disclosure allowed only by judicial order or to officials whose duties entitle them to it. Reporting is how health departments track infections and arrange follow-up. It is not public. If you have a question about what is reported in your case, ask the clinic.

Telling partners

If a test is positive, partners may need testing and treatment too. This can feel awkward, and it is a common step, not a sign of blame. Clinicians and health department staff can help you plan what to say. For chlamydia, Massachusetts law directs the Department of Public Health to allow clinicians to prescribe treatment for the partners of a patient diagnosed with chlamydia, a practice called expedited partner therapy. The CDC's 2024 summary of Massachusetts law lists chlamydia only, so ask your clinician how it applies to your partner.

Cost and insurance

Several sites above list free testing, and others use sliding-scale fees. If you have insurance, a clinic or an outside lab may bill it, and Fenway's page notes that a separate lab bills insurance directly and patients are responsible for that lab's charges. If cost worries you, say so when you call. Ask what is covered before you book.

A simple plan

Pick a site from the list above and call to confirm hours, walk-in rules and cost.
Tell the clinician about any symptoms, recent partners and the kinds of sex you have, so they can choose the right tests.
Ask how and when you will get results, and what to do if you have symptoms while you wait.
If a result is positive, follow the treatment plan, ask when it is safe to have sex again, and talk about partner testing.
Set a reminder to retest on the schedule your clinician suggests.

Getting tested is routine preventive care. Whether or not you have symptoms, a clinic visit is a reasonable next step.

STD Symptoms in Women: Signs, When to Test and Where in Boston