The Wellness Collective

Why STIs Are Commonly Misdiagnosed in Women

Reviewed by Adam Gardner, Licensed Pharmacist & COO of TelyRx

A patient being consulted by her provider.
A patient being consulted by her provider.

Table of Contents

Sexually transmitted infections (STIs) don’t always look the way people expect—especially in women. And when symptoms are vague, misattributed, or entirely invisible, the consequences can be lasting.

Misdiagnosis isn’t rare, either. It’s the reality for countless women navigating a healthcare system that too often overlooks or misunderstands their symptoms. Conditions like chlamydia, gonorrhea, and trichomoniasis are estimated to be more prevalent in women than in men (PMC), yet they’re still underdiagnosed or mistaken for something else.

Women aged 20 to 24 make up the largest group in the U.S. reporting chlamydia infections, and nearly half of all new STDs and STIs occur in people between 15 and 24. These numbers aren’t about promiscuity; they’re about a public health system that often fails to educate, screen, or treat early.

September is Women’s Sexual Health Awareness Month—a time not just for awareness, but for action. That includes breaking the silence around STI symptoms in women, challenging outdated thinking, and making care more accessible with options like online STI treatment.

how STI symptoms present differently in women

Contrary to public perception, STIs don’t always show up as itching, burning, or obvious discharge. In fact, women are more likely than men to have asymptomatic or subtle infections. You may experience:

  • Mild vaginal discharge
  • Pelvic discomfort
  • Intermittent fatigue
  • Spotting or light bleeding between periods

Unfortunately, these symptoms are easily confused with more common conditions like yeast infections, urinary tract infections, or BV (bacterial vaginosis). And because BV and yeast infection symptoms also overlap, many women end up treating the wrong issue while the real one lingers on.

STIs like gonorrhea and chlamydia are more likely to cause long-term health risks in women because they often go unnoticed until complications arise. The World Health Organization reports that these STIs (Sexually Transmitted Infections) are major contributors to pelvic inflammatory disease and infertility in women (WHO).

This is why early testing and awareness is critical. Just because something feels “mild” doesn’t mean it’s harmless.

why misdiagnosis happens more often in women

A provider discusses symptoms with a patient.
A provider discusses symptoms with a patient.

There’s no single reason why STIs are misdiagnosed in women. The complexity of vaginal anatomy and biology makes it difficult to isolate the exact cause of symptoms without testing.

Some of the key reasons include:

  • Hormonal fluctuations – Changes during menstruation, ovulation, or menopause can mimic infection symptoms
  • Mixed infections – It’s possible to have BV and chlamydia, or yeast and trichomoniasis, at the same time
  • Inadequate testing – Many clinics don’t automatically test for all STIs unless a patient specifically requests it
  • Standard tests may miss early infections – Especially if they use less-sensitive swabs or urine-based screening

For many women, it takes multiple appointments and more than one failed treatment before a correct diagnosis is made. That delay can lead to unnecessary discomfort and serious health consequences.

"search history" isn’t a care plan (and DIY fixes can backfire)

When women don’t feel heard by their doctors, they often turn to the internet. TikTok, Reddit threads, and influencer videos are filled with suggestions for handling recurring discharge or irritation. Some of these tips can be helpful; others can make things worse. It’s important to validate the source of their information and ensure it’s backed by professionals.

Boric acid suppositories, hydrogen peroxide rinses, apple cider vinegar soaks, and over-the-counter antifungals are some of the most mentioned. While boric acid might relieve certain symptoms of recurring BV, it doesn’t cure STIs like chlamydia, trichomoniasis, or gonorrhea. In some cases, it can mask symptoms just long enough to delay a diagnosis.

That delay matters. Many STIs need specific medications to fully clear the infection, and self-treatment can interfere with test results. Even something as simple as buying fluconazole online for a suspected yeast infection could backfire if what you actually have is a bacterial infection. Fluconazole treats candida, but that’s all it treats.

Natural remedies might feel empowering in the moment, especially after being dismissed by a provider. But relying solely on Google or influencers can lead to missteps. Real care starts with real answers.

bias and assumptions still block proper STI care

A bottle of antibiotics is shown to a patient.
A bottle of antibiotics is shown to a patient.

Biases in healthcare aren’t always loud. Sometimes, it sounds like “this is probably just a UTI” or “discharge is normal at your age.” These casual comments are common in women’s healthcare, and they often come without a single test being run.

Women report being handed antibiotics with no explanation, or told to wait it out, even when they know something feels off. The problem intensifies for women of color. Black and Latina women are statistically more likely to have untreated STIs, not because they’re more at risk, but because they face more systemic barriers and diagnostic delays (CDC).

Sexual health stigma adds another layer. Some providers avoid in-depth sexual histories altogether out of discomfort or assumption, which means symptoms may get chalked up to hygiene or hormones instead of being properly investigated.

no, it wasn’t because you “weren’t clean enough”

Let’s set the record straight: STDs and STIs are not about cleanliness. You can shower daily, use the best hygiene products on the market, and still contract an infection from a single encounter.

The idea that STIs are the result of being “dirty” or irresponsible is not only wrong; it’s harmful. It reinforces shame and creates silence. And that silence leads to:

  • Delays in seeking testing or care
  • Embarrassment when talking to providers
  • A tendency to self-diagnose or avoid treatment entirely

A recent report found that nearly half of all new STD and STI infections in the United States occur in people between the ages of 15 and 24. These are young people—many of whom are navigating sex and healthcare for the first time—who often don’t seek help because they’re afraid of being judged.

What’s truly “unclean” is a healthcare culture that stigmatizes women for having normal sexual health needs. Infections are common. Compassionate care, unfortunately, is not.

are you playing reinfection roulette? why it keeps coming back

A woman is visibly stressed from her STI symptoms returning.
A woman is visibly distressed by her STI symptoms returning.

You’ve taken the full course of antibiotics. You’ve followed the instructions. So why are your symptoms back?

Reinfection happens more often than people realize. It’s not always about missing a dose or not finishing treatment. In many cases, it comes down to untreated partners.

If you’re treated for an STI but your partner isn’t, you can be re-exposed and reinfected within days. Sometimes, it’s a current partner. Other times, it’s a new one who wasn’t tested. And in some cases, a different infection entirely presents with similar symptoms, creating confusion about what was actually treated in the first place.

This cycle of recurrence can be frustrating and emotionally exhausting. That’s why treating all partners at the same time is so important.

how to advocate for the right diagnosis

If something still doesn’t feel right after treatment, or if your provider never tested you to begin with, it’s okay to ask for more. Here’s how you can advocate for better care:

  • Ask for a full panel that includes chlamydia, gonorrhea, trichomoniasis, and BV
  • Be specific about your symptoms: when they started, how they changed, what you’ve already tried
  • Request a NAAT (nucleic acid amplification test) for better accuracy
  • Track your cycle, discharge, discomfort, and previous treatments in a journal
  • Follow up on results. Don’t assume “no news is good news”

And if your concerns are brushed aside? That’s not your cue to stay quiet. It’s your cue to find someone who will listen, whether that’s a different provider in person or through a telehealth platform.

common medication treatments for STIs

A laptop is opened on the TelyRx website, browsing Z-Paks.
A woman browses the TelyRx website on her laptop.

Many vaginal infections look and feel similar, which is why getting the right diagnosis is everything. Here’s how common conditions are often misdiagnosed, how they’re treated, and how online STD and STI treatments available through TelyRx may help:

Bacterial Vaginosis (BV) is often mistaken for a yeast infection because of discharge and odor. However, BV is bacterial in nature and requires antibiotics like Metronidazole to resolve.

A true yeast infection, on the other hand, is frequently misdiagnosed as BV or even a mild UTI. The go-to treatment is Fluconazole, an antifungal medication that specifically targets candida.

Chlamydia can present with few or no symptoms and is commonly confused with BV, UTIs, or even bladder infections like cystitis. It requires targeted antibiotic treatment, typically Azithromycin or Doxycycline.

Gonorrhea is another bacterial STI that may be misdiagnosed as a general vaginal infection or even pelvic inflammatory disease (PID). Effective treatment usually involves a combination with Azithromycin.

Trichomoniasis is often confused with BV due to its similar symptoms, but it’s caused by a parasite, not bacteria, and needs Metronidazole to clear the infection fully.

If you’ve been treating your symptoms with OTC remedies or the same prescription on repeat without success, it’s worth reconsidering the diagnosis. TelyRx makes it easy to access discreet treatment, with no in-person doctor visits or pharmacy lines.
Starting at $29.99

Acyclovir

Acyclovir is used for the treatment and prevention of the herpes simplex virus (HSV), including oral herpes (HSV-1) and genital herpes (HSV-2).

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Starting at $39.99

Metronidazole vaginal gel

Metronidazole vaginal gel is used for the treatment of bacterial vaginosis.

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Starting at $24.99

Azithromycin

Azithromycin is used for the treatment chlamydia as a single dose.

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Starting at $29.99

Acyclovir Topical

Acyclovir is available as a topical antiviral medication used for the treatment of cold sores and/or genital herpes symptoms. 

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Starting at $17.99

Metronidazole

Metronidazole is used for the treatment of bacterial vaginosis and certain sexually transmitted infections. 

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Starting at $59.99

Imiquimod Topical Cream

Imiquimod is topical prescription indicated for the treatment of genital and perianal warts. 

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Starting at $19.99

Doxycycline Hyclate

Doxycycline is an oral treatment for chlamydia, and a potential solution to gonorrhea as well.

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what to do if you think you’ve been misdiagnosed

It’s frustrating to feel like your body is trying to tell you something and no one’s listening. If you think your diagnosis might have been wrong—or incomplete—there are steps you can take. Start by:

  • Getting retested if symptoms return, persist, or don’t respond to treatment
  • Documenting your timeline of symptoms, partner exposure, and treatment history
  • Requesting additional or repeat tests, especially if the original workup was limited
  • Tracking changes over your menstrual cycle, which can impact symptoms
  • Seeking a second opinion, especially from someone experienced in sexual health or who offers full-panel testing

Being misdiagnosed doesn’t mean you did something wrong. But it does mean you’re still searching for the care you deserve.

it’s time to be heard—and helped

If you’ve ever felt like your symptoms were ignored, your questions brushed off, or your care rushed, you’re not imagining it. But you deserve better.

You deserve to feel confident in your care, not confused by it. You deserve answers without judgment, and access to treatment without long waits or uncomfortable conversations. You deserve a provider who doesn’t assume or dismiss, but listens, tests, and treats with intention.

At TelyRx, we believe that your sexual health is just that—yours. Whether you’re dealing with recurring symptoms, trying to make sense of conflicting diagnoses, or just want a discreet, reliable way to get treated, we’re here to support you.

If you’re ready to break the cycle of misdiagnosis and finally get the treatment you deserve, we’re here to help you take that first step.

FAQs

is it safe to buy STI medications online?

If you use a certified, licensed telehealth platform like TelyRx, yes. All of the medications we carry are from U.S.-based wholesalers and FDA-approved, often from the same manufacturers you would expect to see from CVS or Walgreens.

BV is a bacterial imbalance, not a sexually transmitted infection. But it shares similar symptoms, and it can increase your risk of contracting an STI if left untreated.

Be honest. Let them know you’re being proactive about your health, and you want them to be too. TelyRx can discreetly facilitate telehealth treatment requests for both of you without the need for awkward scheduling or pickup.

If something feels off, it’s always a good idea to seek testing through a clinic, local health provider, or telehealth service. Getting a clear diagnosis is the first step toward effective treatment. Once you’ve identified the cause, TelyRx can assist with treatment.

Nope, you don’t need insurance to access STI medications through TelyRx. We believe everyone deserves fast, affordable care, with or without coverage. All of our prices are transparent, there are no surprise fees, and you’ll never be asked for insurance info to place an order.

Disclaimer

This blog post is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. The content provided here is not a substitute for professional medical advice, consultation, or care from a qualified healthcare provider. Always seek the guidance of your physician or another licensed health professional with any questions you may have regarding a medical condition or treatment. Do not disregard or delay seeking professional medical advice based on information read on this site. Learn more about our editorial standards here.

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