Julie Medical Advisor
What are STDS?
If you recently found out you have a sexually-transmitted infection (STI), also referred to as a sexually transmitted disease (STD), or have a partner that does, it’s normal to feel overwhelmed or worried. The first thing to know is that these infections are very common and more people have them than you probably think. Each year there are an estimated 374 million new infections with 1 of 4 curable STIs: chlamydia, gonorrhea, syphilis and trichomoniasis, and even more diagnoses of manageable STIs like herpes and HIV It’s possible to fully recover from some of these infections, but it’s important to get treatment right away before they cause lasting harm to you or your partner(s). This article covers what you need to know about STIs, common symptoms, how to have sex with them, treatment, and how to protect yourself and your partners.
STIs and STDs: What’s the difference?
Sexually-transmitted infections (STIs), like chlamydia and gonorrhea, are infections that can be passed from person to person during sex. This happens through blood, semen, vaginal fluid, and other bodily fluids. The likelihood of contracting an STI increases when you have unprotected sex, so using barrier protection, like a condom, is a great way to protect yourself.
Sexually-transmitted diseases (STDs) and STIs are terms that are often used interchangeably, but they’re not actually the same. STIs cause STDs, but STIs aren’t technically STDs until symptoms occur. You can have an STI and not experience any symptoms, which makes it easy to give it to someone else without knowing. Some of the most common types of STIs include HPV, crabs (lice), chlamydia, gonorrhea, and syphilis.
How do you get them?
STIs are passed through bodily fluids and/or physical contact, but they’re not always contracted through sexual intercourse. You can become infected with certain STIs through blood transfusions or needle sharing, and mothers can pass certain STIs to their newborns during childbirth if the mother already has an uncontrolled STI. The incubation period, or how long it takes to start seeing symptoms, is different for every person and for every STI. In fact, many people don’t even know they have an STI. The only way of knowing is to be tested.
Common STI Symptoms
It’s common to have an STI without any symptoms, but physical symptoms can be a good indicator that you have one. So if you think you’ve been exposed to an STI, start noticing abnormal things going on with your body, or if you think you have any of the symptoms below, get tested as soon as possible:
Sex tip: Get tested when you start having sex with someone new, just in case one of you has an STI without any symptoms. If you’re under 25, it’s recommended to get tested every year.
Here are some of the most common STI symptoms:
Pain or burning during urination
Pain or a burning sensation, when you pee, can be caused by an STI such as chlamydia or gonorrhea, but it could also be a sign of a urinary tract infection (UTI). If you have a UTI, you might feel like you need to pee more often, but you’re unable to. Your urine might also look cloudy or have an unusual smell. Both can easily be diagnosed by a doctor.
Unusual vaginal bleeding
There are many reasons why you could be experiencing unusual bleeding (light or heavy). It could be an underlying gynecological condition, but it could also be from an STI. Chlamydia is the usual culprit since it’s known to cause inflammation.
As with the flu, a fever is usually a sign that your body is fighting an infection. This symptom is typically linked to chlamydia, gonorrhea, HPV, and HIV. It also might be a sign that the infection is more widespread, so it’s always safest to see a doctor as soon as possible.
Pain during sex
STIs can cause sensitivity that leads to pain or discomfort during sex, especially penetrative sex, i.e. the kind where a penis or dildo enters a vagina or anus. If you feel pain, bleeding may also occur after intercourse. Check-in with your doctor to make sure that something serious isn’t going on.
Sores or bumps
Sores, bumps, and warts can vary in size and appearance and are usually an indicator of an STI. They might look flat, raised, or cauliflower-shaped. Some are very painful, and others are painless. Someone experiencing this could have genital warts (HPV), herpes, or syphilis, but it’s best to check in with a doctor ASAP to make sure you get the right treatment.
Rashes can appear anywhere on your body and vary in color. Some can be irritating or not itch at all. In the case of syphilis, they can be found on the palms of your hands, feet, in your mouth, or around your vagina or anus. Syphilis is easily treated but should be addressed immediately.
Sore or swollen lymph nodes
Sore or swollen lymph nodes are another common and uncomfortable symptom. Swollen lymph nodes can occur around your groin, rectum, or pelvis. If you feel like your lymph nodes are swollen, check in with your doctor.
Unusual vaginal discharge
Vaginal discharge is totally normal and can change in frequency, amount, color, consistency, and smell. But when we talk about STIs, we’re referring to abnormal vaginal discharge, which may be thick, itchy, yellow or green in color, and foul-smelling. If you notice any discharge that is different from what you’re used to seeing, reach out to your doctor.
List of Common STIs
There are a lot of different STIs out there. Here are some of the most common:
Referred to as “the clap” or “the drip,” gonorrhea is a bacterial infection and is one of the most common sexually transmitted infections, especially among people ages 15 -24. The good news is it’s very treatable.
Chlamydia is a bacterial infection and, like gonorrhea, it’s one of the most common STIs. It’s usually seen in young people and is very treatable.
Like other bacterial infections, syphilis can spread through oral, anal, or vaginal sex. If left untreated, it can cause permanent damage, but it’s easily treated if detected early.
Herpes simplex virus (HSV types 1 and 2)
Herpes is a virus that can cause painful ulcers on your genitals and mouth. Although you can never get rid of the virus, there are medications to help manage the symptoms and cause fewer outbreaks. The medications can also reduce the risk of passing the virus on to a partner.
Human Papillomavirus (HPV)
HPV is the most common STI. The body often fights off infection on its own, but in some cases it can lead to genital warts, penile cancer or oral cancer. It’s also the main cause of cervical cancer. You can protect yourself from the most harmful strains of the virus (those that cause warts and cancer) with the HPV vaccine.
Hepatitis B is a viral strain that can cause liver disease. It’s usually spread by coming into contact with infected bodily fluids and can sometimes lead to yellowing of the eyes, abdominal pain, and dark urine. It can be prevented with a vaccine.
Human Immunodeficiency Virus (HIV) is a virus that breaks down the cells in the immune system and weakens its ability to fight infection. HIV is the virus that causes AIDs. There’s no cure, but there is a treatment that can help people with HIV live long healthy lives.
Crabs (Pubic Lice)
As one of the most common STDs, pubic lice–also known as crabs—are small parasites that attach to the skin and hair near your genitals and feed on your blood, causing intense itching. It can be treated with a topical pyrethrin lotion or mousse.
Treatment can look different depending on what STI you have, but most have great management options. Depending on your symptoms and test results, there are two classes of medications that your doctor may prescribe you:
- Antibiotics: As the most common form of treatment for bacteria, a course of antibiotics can help cure bacterial STIs like gonorrhea, chlamydia and syphilis. While most antibiotics can be taken orally, intramuscular injection is often used for gonorrhea, which has a growing problem of antibiotic resistance. It’s important to finish your antibiotic treatment once you start it. If you have sores, you should abstain from sex until you heal. Experts also recommend that women be retested in about three months because there's a high chance of reinfection.
- Antiviral: If you have a STI like herpes or HIV, your doctor will likely prescribe an antiviral drug. Viral infections can’t be cured, but antiviral drugs can help to manage them. The sooner you begin treatment with an antiviral drug, the more effective it will be. When taken regularly and as prescribed, these drugs can reduce the viral load and reduce the risk of passing to a partner.
- Pyrethrins: Pyrethrins are naturally-occurring compounds with insecticidal properties that are found in pyrethrum extract from certain chrysanthemum flowers. The pyrethrins are often used in household insecticides and products to control lice, in addition to human “pubic” lice also known as crabs. Most products can be purchased over the counter, and some are prescription. It is important to follow the directions on the package. It is also important to let your partner know so that they can be treated as well.
Some treatment methods also include surgery or laser removal, but those are only for specific infections.
If you’re sexually active, getting tested for STIs is one of the most important things you can do to maintain your health and protect your body, as most infections can cause lasting damage if left uncontrolled. This might involve going through your sexual history with your doctor, but the more you can tell them, the more accurately you can be tested and treated. If you’re uncomfortable speaking to your doctor about this, there are many clinics that provide confidential and low-cost testing.
When to take a test
There are two different indications to get tested: routine screening and symptoms/exposure concerns. In the United States, it’s recommended that everyone get tested for HIV after their first time having sex. Thereafter, testing in females having vaginal sex should be once yearly until the age of 25 and then/or with new partners or high-risk scenarios. Men who have sex with men should also be tested yearly. As needed testing (as previously discussed) is recommended if experiencing symptoms or following a known infection in a partner..
How long after sex
STIs like gonorrhea, chlamydia, and syphilis can take anywhere from a few days to a few weeks to show up. HIV can take up to 3 months to show up on a test. If you feel like there’s a possibility that you could have contracted an STI, it’s generally appropriate to get tested two weeks after unprotected sex, then follow-up testing as needed.
What does testing look like?
Tests are performed and confirmed in a laboratory and may require a urine sample, cheek swab, vaginal swab, urethral swab, a scraping from a skin lesion or a blood test. Besides blood testing, the basic STI testing is generally noninvasive and private, meaning those with female anatomy swab their own vaginas with a collection swab and those with male anatomy pee in a cup. As one gets older or depending on comfort level, cervical samples can also be collected via a pap smear.
The most effective way of avoiding STIs is not to have sex. In reality, that doesn’t always happen. If you’re sexually active, here are some ways to prevent yourself from contracting an STD.
- Check-in with your partner about recent testing or do a quick body scan for concerning growths or sores
- Do the same check-in that you ask of your partner. Be responsible about having symptoms or exposures tested and treat when indicated.
- Use condoms or other barrier methods (like dental dams) to reduce the risk of coming in contact with bodily fluids.
- Vaccines: Getting vaccinated before sexual exposure is a very effective way to prevent certain types of STIs. Currently, there are vaccines for both HPV and hepatitis B. The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for girls and boys starting at age 9 and the hepatitis B series for all infants.
Safe sex with a partner that has an STI
There are certain things you can do to lower your risk of contracting an STI from a sexual partner:
Get tested and share your results
First, get tested and have an honest conversation about your results. This can be a difficult conversation, but it allows both you and your partner to make informed decisions for your health and your sexual relationship.
In 38 states, physicians can actually write a prescription for a patient’s partner for treatment of gonorrhea or chlamydia. This is called expedited partner therapy. You can also get the HPV vaccine to help lower your chance of contracting that virus. It’s FDA approved for ages 9 to 26 and has shown to be effective in preventing numerous strains of the HPV virus.
If your partner has genital herpes
Unfortunately, herpes is not treatable but is definitely manageable. If you or your partner has herpes, there are some antiviral medications that can help reduce (but not eliminate) the risk of spreading herpes to a partner. Another factor that can reduce the risk of spreading herpes to a partner is a condom, though the risk still exists as herpes spreads from skin-to-skin contact. Studies have shown that people with genital herpes taking antiviral medications are able to reduce the risk of passing it to their partner by 75%. When you add a condom, the risk is even lower.
It’s also important to know that if you and your partner have the same STI, that doesn’t mean you’re automatically safe. It is possible for two partners with the same STI to infect each other with a different strain, so it’s always best to use protection.
Explore other types of sex
One way to be sexual with a partner who has an STI is to explore other ways of being intimate, like foreplay, stroking, and mutual masturbation. Oral sex may also be a safe option for many couples.
Reduce partners and use protection
Reducing your number of sexual partners can also help lower your risk. Latex condoms, female condoms, and dental dams (a piece of rubber that covers the genitals during oral sex) can all help prevent the spread of STIs.
How to tell your partner
Did you test positive for an STI? Letting all of your potentially-exposed partners know is one of the most important things you can do. While it might feel embarrassing, remember that these infections are incredibly common. In fact, more than 1 million STIs are contracted every day.
Sharing your test results with your partner(s) can be helpful as well as explaining general information about the particular STI. Everyone is different when it comes to getting news like this, but one of the most important messages is to encourage your partner to get tested so they can know their status as soon as possible.
In some states, healthcare professionals offer Partner Notification Services that will reach out to your partners for you and refer them to get tested.
Protecting you and your partner
The best way to protect you and your partner from STDs is through open communication, regular testing, and barrier protection (like condoms and dental dams). It can be hard to know if you or someone else has one without talking about it or taking the proper precautions. Our after-sex checklist can help remind you to check in with your body after sex and lower your risk of infection. If you notice symptoms, see sores, or begin to feel discomfort, and you think you might have been at risk of contracting an STI, get tested as soon as possible.
This article is for informational purposes only and does not constitute medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
There are a few medications that may interact with the morning-after pill. The most common medications include:
-Some anti-HIV medications
-Some anti-seizure medications
-Rifampin (an antibiotic mainly used to treat tuberculosis)
-St. John’s wort
If you have concerns about a medicine you are taking potentially interacting with the morning-after pill, please consult with a pharmacist or medical provider.
No, studies have confirmed that taking two pills will not change the effectiveness of the morning-after pill, even for those with higher BMIs.
Essentially nothing. Julie is not an abortion pill and it will not harm or end an existing pregnancy. Julie helps prevent pregnancy by stopping or delaying ovulation, but if you’re pregnant, then there’s no ovulation to stop. The medication, levonorgestrel, won’t harm you or your fetus if you do end up taking Julie while pregnant. This makes Julie a great option for people who want to be safe after unprotected sex—if you aren’t pregnant yet, it may stop a pregnancy from occurring, and if you are already pregnant, it won’t impact the fetus.
No. The morning-after pill only stops ovulation short-term. When you take it after unprotected sex, it reduces your chance of getting pregnant now. When you start a new cycle next month, you’ll go through a brand new ovulation phase, which is a new opportunity to get pregnant. So if you’re planning on having babies in the future, rest assured your chances of getting pregnant won’t be affected by Julie.
After taking Julie you can continue on with your regular birth control method if you have one (for example, continue taking birth control pills).
You will know Julie has been effective when you get your next period, which should come at the expected time, or within a week of the expected time. If your period is delayed beyond 1 week, it is possible you may be pregnant. You should get a pregnancy test and follow up with your healthcare professional.
Julie is a backup or emergency method and should not be used as a regular birth control method. Consult with your doctor about a birth control method that makes sense for you.
Please know that taking a dose of Julie will only protect you from one instance of unprotected sex, it will not prevent pregnancy from unprotected sex over the coming days or weeks. If you have unprotected sex in the future and want to prevent pregnancy, be sure to take a new dose of Julie and talk to your doctor about the best birth control options for you.
Your menstrual bleeding patterns may change temporarily after using levonorgestrel. If you find that your period is more than a week late, take a pregnancy test to confirm whether the contraceptive has worked.
Technically, no. Julie can be used by anyone with a uterus regardless of weight. However, studies have shown that the effectiveness of the morning-after pill does decrease in people who have a body mass index (BMI) over 25. For those with a BMI under 25, pregnancy risk after taking the morning-after pill is less than 2%. For those with a BMI over 29.9, the risk of pregnancy increases to 5.8% - meaning that out of every 100 individuals with a BMI over 29.9 who take Julie, six may become pregnant.
Why? Unfortunately, we don’t really know. There is only preliminary research testing the efficacy of the morning-after pill on people with a BMI over 25 and 30. Read more here.
Julie is not an abortion pill and will not harm an existing pregnancy nor will it be effective if a woman is already pregnant.
Julie is a progestin‑only emergency contraception product that helps prevent pregnancy before it starts when taken within 72 hours after unprotected sex.
Julie is a backup method of preventing pregnancy and should not be used as regular birth control. Use as directed.
The medication in the morning-after pill, levonorgestrel, temporarily blocks or delays ovulation, which is when your ovary releases an egg. It essentially puts the emergency brakes on your ovaries so an egg can’t be released. If there’s no egg, then there’s nothing for sperm to fertilize, which means a pregnancy can’t develop.
Read more about how the morning-after pill works here.
The morning-after pill, like Julie, is 89% effective when taken within 72 hours (or 3 days) after unprotected sex. The golden rule is the sooner you take it, the better it will work.
One thing to note: Weight does impact the effectiveness of the morning-after pill. If your BMI is over 25, Julie may not be the best option for you, but there are other options if you have access to a medical provider. Ella® is another type of emergency contraception pill that works more effectively for women with a BMI under 30. Like Julie, it’s a one-time pill but it does require a prescription from your provider. Copper and hormonal IUDs are the most effective form of emergency contraceptive and are not affected by weight at all. However, they do need to be inserted by a healthcare professional up to 5 days after having unprotected sex.
Learn more about how weight impacts Julie here.
You do not need to see a doctor before or after taking Julie because the pill is available without a prescription. However, there are a few reasons you might want to speak with a doctor after unprotected sex. The first reason is that unprotected sex carries the risk of catching sexually-transmitted infections. The second reason is that the morning-after pill is not as effective as regular birth control. A doctor will be able to counsel you on better options if you plan to remain sexually active.
Since emergency contraception can affect the length of your menstrual cycle, your period might come about a week later or earlier than usual after taking Julie. If your period is more than one week late, consider the possibility of pregnancy.
No, the morning-after pill (including Julie) and the abortion pill are two very different medications. The morning-after pill prevents a pregnancy from starting by stopping an egg from being released. If there’s no egg, there’s no chance of pregnancy. Plus, it’s FDA-approved and legal in all 50 states.
On the other hand, the abortion pill ends an existing pregnancy, which is something that the morning-after pill cannot do. If you’re already pregnant, the morning-after pill and the medicine within it, levonorgestrel, cannot end the pregnancy or impact it in any way.
See more common morning-after pill myths here.
No. No one needs a prescription to purchase Julie or EC. However, some insurances require a prescription for reimbursement. Some pharmacies and places where EC is sold may tell you that you need a prescription. You do not.
The morning-after pill—like Julie— is one of the most common and convenient forms of emergency contraception. It’s an over-the-counter pill found at retail chains like Target, CVS, and Walmart nationwide. The morning-after pill is made of the hormone levonorgestrel, the same hormone found in many birth control pills and is FDA-approved and legal in all 50 states. When used correctly, it can significantly reduce your chance of getting pregnant. It doesn’t require a prescription, ID, or credit card, and can be purchased easily by anyone (you, your partner, your friend, or the nice guy from GoPuff). Learn more about the morning-after pill here.
The morning-after pill is a backup method of preventing pregnancy and should not be used as regular birth control.
You should take Julie if you had unprotected penis-to-vagina sex and:
- You didn’t use any form of birth control
- Your birth control method failed—e.g. the condom broke or slipped off
- You missed 2 or more doses of your regular birth control pill
- You’re not sure if he pulled out in time
Remember to take Julie ASAP to have the best chance of it working. It’s 89% effective when taken within 72 hours of unprotected sex, but can be effective up to 120 hours after. Learn more about Julie here.
No. No one needs a prescription to purchase Julie or other brands of the morning-after pill. However, some insurance companies require a prescription for reimbursement. Some pharmacies and other places where emergency contraceptives are sold may tell you that you need a prescription. You do not.
Take the Julie tablet orally (swallowed). It is preferable to take it with water, and you can take it with or without food. Do not insert Julie vaginally.
No. We know this is a common misconception so let’s break it down. Using Julie (no matter how many times you take it) does not affect your fertility — and it will not prevent you from becoming pregnant in the future. You should feel free to use Julie whenever you think it’s necessary. Julie (and all EC) is not recommended as an ongoing form of birth control because it’s not as effective at preventing pregnancy as birth control methods like the IUD, patch, pill, ring, or shot. Also, frequent use of EC may cause periods to become irregular and unpredictable. That’s it!
You can get Julie at your local CVS, Target, Walmart or on our website.
No, that’s not recommended. Emergency contraceptives, like Julie, work when you take them after sex. That’s because emergency contraception prevents pregnancy by delaying when you ovulate, which is when an egg is released from the ovary. Sperm can live inside you for up to 5 days, so if you take Julie and then have unprotected sex, the medication might not be able to delay ovulation for the entire length of the sperm’s life, creating a potential for pregnancy.
Learn more about how Julie works here.
Yes. You are not alone. Often times, people who buy EC are feeling stressed out, concerned, embarrassed, confused or ashamed. The important thing to remember is that you are not alone, you have nothing to be ashamed about, and the Julie community is here to support you. By taking Julie after unprotected sex, you are taking control of your future and taking a safe, effective, approved method of preventing pregnancy.
Julie and other over-the-counter morning-after pills contain a high amount of levonorgestrel, a synthetic hormone that’s also in some birth control pills. The extra amount of this hormone can affect your menstrual cycle and cause some side effects. Most side effects come and go within hours of taking the pill, but some can last up to a couple of days. Learn more about Julie's side effects here.
- Bleeding/spotting between periods
- Temporary changes to a period cycle (the next period comes early or late)
- Heavier or lighter next period
- Abdominal pain
- Breast tenderness
For more information about Julie side effects and how long they last, read this.
Side effects like nausea, abdominal pain, and fatigue can start within a few hours of taking the morning-after pill. If you vomit within two hours of taking the pill, it’s important to talk to a healthcare professional to find out if you should take another dose.
Most side effects are easily manageable, but sometimes they can be annoying. If that headache just won’t go away or your breasts are super tender, it’s safe to take ibuprofen, acetaminophen, or any over-the-counter pain reliever—they won’t interact or interfere with levonorgestrel.
Listen to your body. After all, you’ve just taken a pill that affects your hormones. Feeling a little weird is normal. Rest, keep yourself hydrated, and give yourself some extra compassion.
No. Julie is not what is commonly called “the abortion pill” or “medication abortion”. The active ingredient in the abortion pill is mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing. Julie does not and will not impact an existing pregnancy, and works by delaying ovulation before there is a pregnancy.
The FDA recently made an update in December 2022 to remove any language suggesting that Julie may prevent implantation of a fertilized egg. We are currently working on removing this outdated disclaimer but you may still see it present on some of our packaging in the meantime. Please disregard these statements because they are out of date. Julie will not impact an existing pregnancy.
Your cycle might be temporarily affected after taking Julie. That’s because there’s a higher dose of levonorgestrel compared to what’s found in daily birth control pills. It’s likely to impact your body’s natural hormone levels for a short period of time. This might result in an earlier or later period.
If your period is delayed beyond one week, it is possible you may be pregnant. You should get a pregnancy test and follow up with your healthcare professional if positive. Your period might also be lighter or heavier than usual, or you might experience spotting in between cycles. If your schedule is impacted beyond a month or two, it’s worth checking in with your medical provider. Read more about how Julie might affect your period here.
No! The most common side effects are changes in your period, nausea, lower stomach pain, fatigue, headaches, dizziness, and breast tenderness. These symptoms typically go away within a few hours and shouldn’t last more than a couple of days. If you have any side effects that bother you, call your healthcare professional. Read more about Julie's side effects here.
Yes. You are not alone. Oftentimes, people who buy EC are feeling stressed out, concerned, embarrassed, confused or ashamed. The important thing to remember is that you are not alone, you have nothing to be ashamed about, and the Julie community is here to support you. By taking Julie after unprotected sex, you are taking control of your future and taking a safe, effective, approved method of preventing pregnancy. If you want to share your experience and talk with others in our community, head to our Tik Tok, Instagram, and Quora space, After Sex, where all sex questions and commentary are welcome.
It depends. Some people get their period a few days earlier or later than they were expecting, while some have reported a delay in menstruation beyond a week. Stress can also delay your period, which can be heightened when taking emergency contraception. If your period is more than one week late, it doesn’t necessarily mean that you’re pregnant, but it is recommended to take a pregnancy test.
Waiting for your period to arrive can be stressful, especially after taking emergency contraception, but just know that it might be totally normal. A delayed or early period is actually one of the most common side effects of taking the morning-after pill. Levonorgestrel, the hormone in Julie, delays ovulation, which can move the timing of your cycle back a few days. Your period might also be lighter or heavier than usual, or you might experience spotting in between cycles. If your period is delayed beyond one week, it doesn’t necessarily mean that you’re pregnant, but it is recommended to take a pregnancy test. You can read more about how Julie might affect your period here.
The best thing to do after taking Julie is to rest and hydrate. If you’re feeling any side effects, you can take over-the-counter painkillers to make yourself feel more comfortable. A heating pad or hot water bottle can also help if you’re having stomach pain or cramping. If you can, a day on the couch with Netflix or a good book often does the trick. Read more about managing Julie side effects here.
Typically just for one menstrual cycle. Most people notice that their period starts either a few days early or a few days late, though some people have reported a two-week delay in menstruation. If you are not pregnant, your cycle should return to normal the next time you get your period. If changes last beyond a month or two, it’s best to check in with a doctor.
Read more about changes to your period after taking Julie here.