STD Symptoms in Receptive Anal Sex

Schematic of the Rectum

Schematic of the Rectum

It is possible to get infection such as HPV in the Anus even if you do not have anal sex.

This article will focus on what kind of STD symptoms can get if you do have anal sex regardless of whether you are a man or woman.

This includes allowing your partner to insert his penis into the anus, allowing your partner to use his/her mouth on the anus, allowing your partner to insert any objects into the anus including fingers and sex toys.

Symptoms can basically be divided into 3 groups:

1. Anal Symptoms – Discharge, Discomfort, Bleeding etc

2. Skin symptoms – Ulcers, Blisters, Growths etc

3. General Symptoms – Fever, Swollen Lymph Nodes etc

1. Anal Symptoms

It is very important to remember that most STD infections of the Anus will not show any symptoms at all. Possible symptoms are:

– Discharge. This is basically a liquid coming out of the anus. Very rarely it is yellow and high volume. If this is so, it is almost always due to Gonorrhea. More often than not, it is very mild and a mucus like appearance and consistency. Sometimes patients do not even see a discharge but they feel that the anus is wet all the time. Discharge from the anus is commonly caused by Chlamydia or Gonorrhea.

– Discomfort. This can range from actual discomfort to feeling like they need to poo all the time. It is never actually painful. If it is painful, it is more likely due to piles or an anal fissure rather than an STD.

– Bleeding. This is also a rare symptom of an STD infection. If we see bleeding we would more often think of piles and anal fissures.

Who are the culprits?

– Chlamydia

– Gonorrhea

When do these symptoms usually appear?

Most of the time, symptoms do not appear at all. If they do, it can be as early as 2 to 3 days after infection or as late as 1 month.

2. Skin Symptoms

Peri-Anal Warts

Peri-Anal Warts

These are actually the same symptoms you will find on the pubic or genital region.

– Growths. This is extremely common and is usually caused by HPV. HPV can infect the anus even if you do not have anal sex. HPV infection of the anus can cause Anal Cancer. For all these reasons you really should think about getting a HPV vaccine. This vaccine is recommended for both men and women. Remember, you can get HPV infection of the anus even if you do not have anal sex. Growths due to HPV are called warts. They look very distinctive. They are often described as skin colored ”cauliflower-like” growths. When they grow around the anus they are usually multiple (a few to a lot of them). They can even grow inside the anal canal which makes it very difficult to treat. Because you may not be able to see them, you will usually notice them when you feel soft little lumps around the anus. Another less common growth due to an STD is caused by Molluscum Contagiosum Virus. This looks like little pearls that have been stuck to the skin.

– Ulcers. The 2 usual suspects are Syphilis and Herpes. Syphilis ulcers are usually single, big and painless. Herpes ulcers are usually multiple, small and painful. Because these ulcers can occur inside the anal canal, you may not see them.

– Blisters. This is almost always caused by Herpes. They look like little fluid filled sacs on the skin. They do not usually appear around the anus instead would appear on the butt cheeks. They can cause the lymph nodes in the lower back to swell and cause a bit of a back pain.

Who are the culprits?



Molluscum Contagiosum Virus


When do these symptoms usually appear?

Syphilis 9 to 90 days. Herpes can be within a week or can take months. This also applies to HPV which commonly appears at 3 to 6 months post infection.

3. General Symptoms

These symptoms are called general symptoms because they can be caused by a variety of illnesses and not necessarily by STDs.

– Fever. The STDs that affect the anus almost never causes fever except for HIV. Click here for more info on HIV symptoms including HIV Fever. So if you do have a fever, more likely than not it is not due to an STD.

– Swollen Lymph Nodes. Lymph nodes close to any area that is infected will swell as part of the body’s natural defense mechanism against an infection. If the anal canal is infected the lymph nodes in the lower back can swell and even become a little tender or painful. This can occur with Herpes, Syphilis, Gonorrhea or Chlamydia.

Who are the culprits?





When do these symptoms usually appear?

Swollen lymph nodes, if they do appear, will happen after the other symptoms have occurred.

What to do now?

If you have any of the above symptoms, see us to get some tests done.

If you have not had any symptoms but engage in anal sex, you might also want to get screened especially for HPV.

Speaking of HPV, it is highly recommended for everyone, both men and women to get the HPV vaccine.

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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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  1. Hi dr tan.

    Do all hpv genital warts are confirm as std?

    • Human Papilloma virus can be transmitted via sexual activity eg receptive anal sex or rimming. So effectively genital HPV warts are infact STDs.


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