Whispers of “blue waffle disease” began around 2010. That was when a disturbing image of blue-tinted, pus-covered, lesion-filled labia started circulating online.

Online users claimed that it was the result of a sexually transmitted infection (STI).

While that’s definitely labia in the picture, blue waffle disease is not real. But to this day, the picture remains a pervasive — and fake — meme.

We debunk the myths around blue waffle disease and clear up how real STIs are acquired — and how to check for them.

The claims that went along with the photo were almost as disturbing as the image itself. Users maintained that blue waffle disease was an STI that only occurred in people with vaginas. Another widespread claim was that this fictional STI developed exclusively in females with many sex partners.

The name came from the slang terms “waffle” for vagina and “blue waffle” for a serious vaginal infection. Blue waffle disease was rumored to cause lesions, bruising, and blue discoloration.

As it turns out, the medical world does not recognize any disease with that name or that causes those symptoms — at least not the “blue” part. There are, however, several STIs that can cause discharge and lesions in sexually active people who contract the viral or bacterial infection.

Blue waffle disease may not exist, but many other STIs do. If you’re sexually active, it’s important to know that your risk of contracting an STI increases. You may want to consider checking your genitals regularly for signs of an STI.

Here are the signs and symptoms of the most common STIs.

BV is the most common vaginal infection in women between ages 15 and 44 years, according to the Centers for Disease Control and Prevention (CDC). It occurs due to an imbalance of bacteria normally found in the vagina.

It’s not entirely clear why some people get it, but certain activities that can alter vaginal pH balance increase risk. These include having new or multiple sex partners, and douching.

BV does not always cause symptoms. If it does, you may notice:

  • thin vaginal discharge that is white or grayish
  • a fishy odor that becomes worse after sex
  • vaginal pain, itching, or burning
  • a burning sensation during urination

Chlamydia is common and can occur in people of any sex. It’s transmitted through vaginal, anal, or oral sex.

Without treatment, chlamydia can cause serious complications and affect female fertility. It’s curable but only if both you and your partner(s) receive treatment.

Many people who have chlamydia have no symptoms. If you develop symptoms, they can take several weeks to appear.

Vaginal symptoms may include:

  • abnormal vaginal discharge
  • burning when urinating

Symptoms affecting the penis or testicles can include:

If you have anal sex or chlamydia spreads to the rectum from another area, such as the vagina, you may notice:

  • rectal pain
  • discharge from the rectum
  • rectal bleeding

All sexually active people can contract this STI. Gonorrhea can affect the genitals, rectum, and throat and is transmitted through vaginal, anal, or oral sex with someone who has it.

Gonorrhea may not cause any symptoms. The symptoms that can occur depend on your sex and the location of the condition.

A person with a penis may notice:

A person with a vagina may notice:

Rectal infections may cause:

Genital herpes can be caused by two types of the herpes simplex virus (HSV):

  • HSV-1
  • HSV-2

It’s primarily transmitted through sexual contact. Most instances of genital herpes occur due to HSV-2.

Once you’ve contracted the virus, it lies dormant in your body and can reactivate at any time. There is no cure for genital herpes.

If you have any symptoms, they usually begin within 2 to 12 days after exposure to the virus. Approximately 90 out of 100 people with genital herpes will have very mild or no symptoms.

During an initial herpes outbreak, symptoms might include:

  • long-lasting lesions
  • increased viral shedding, meaning that HSV is more likely to pass to others during this time
  • fever
  • swollen lymph nodes
  • aches across the body
  • headache

Once these symptoms resolve, herpes effects can occur over and over. During an outbreak, symptoms are generally less severe than in the initial outbreak and probably won’t last as long.

Symptoms of recurrent outbreaks include prodromal symptoms.

In herpes, these take the form of genital pain and shooting pains in the lower body and usually develop a few hours or days before lesions become apparent. These prodromal symptoms can give you a heads-up that you’re experiencing a herpes outbreak.

HPV is the most common STI. According to the National Cancer Institute, there are more than 200 types of HPV. Of the many different types of HPV, 40 types can infect the mucous membranes, which includes the genitals, rectum, and mouth.

Most sexually active people will acquire some type of HPV during their lifetime. It’s passed through skin-to-skin contact and can affect your genitals, rectum, mouth, and throat.

Some strains can cause genital warts. Others can cause certain cancers, including cancers of the cervix, rectum, mouth, and throat. The strains that cause warts are not the same as those that cause cancer.

Cancers that can develop due to HPV include:

  • cervical cancer
  • oropharyngeal cancers
  • anal cancer
  • penile cancer
  • vaginal cancer
  • vulvar cancer

Most HPV infections resolve without treatment and don’t cause any signs or symptoms, but the virus remains dormant in your body and can be transmitted to your sexual partners.

Genital warts due to HPV can appear as a small bump or a cluster of bumps in the genital area. They can range in size, be flat or raised, or have the appearance of a cauliflower.

Genital warts caused by HPV are not the same as genital herpes.

If you notice any unusual changes, such as discharge, bumps, or sores, see your doctor for STI testing as soon as possible.

In 2018, the last time the CDC collected stats around the topic, around 20 percent of the U.S. population was living with STIs. No one has blue waffle disease – because it does not exist.

Many among this number haven’t yet received a diagnosis — and not only due to the subtle or non-present symptoms of STIs.

STI testing continues to carry an unhelpful stigma that serves as a barrier between people with treatable conditions and the care they need.

Without treatment, some STIs can progress to complications that lead to infertility and some cancers. It’s vital to make sure that sexually active people have a comfortable relationship with STI testing.

Who needs STI testing?

Sexually active people would likely benefit from STI testing. It’s especially important if:

  • You’re starting a sexual relationship with a new partner.
  • You and a partner are about to start having sex without a condom or other barrier contraceptive methods.
  • You regularly have sex with multiple partners.
  • Your partner has had sex outside of the relationship or has multiple partners.
  • You’re experiencing symptoms that might indicate the presence of an STI.

People in monogamous, long-term relationships may not need STI testing if they underwent screening before their relationship started. But many people don’t get screened. It’s important to rule out any STIs that do not produce obvious symptoms before they develop into a more harmful complication.

STIs you should test for

Seek a healthcare professional’s advice about the STIs for which testing would be beneficial for you. Everyone has different sexual circumstances, and it’s best not to have too many concerns about STIs you’re unlikely to have.

A physician or healthcare professional might recommend testing that identifies the following:

It’s unlikely that they’ll request a herpes test unless you’ve potentially had exposure to it or requested the test specifically.

At your regular sexual health screening, they’re unlikely to check for all these STIs. Many healthcare professionals don’t check for any STIs as a routine measure.

Be sure not only to ask your doctor about STI testing but also to confirm which tests are taking place. Openness and honesty are key, as talking candidly about your STI risk will help a healthcare professional work out which tests to recommend.

Testing in response to non-consensual sexual activity

Sexual violence can be isolating and traumatizing experiences alongside any potential health impact like STIs.

If someone has forced you into any sexual activity, or you’ve lived through sexual violence, it’s important to consider speaking with a healthcare professional.

You can seek support from the Rape, Abuse & Incest Network (RAINN) via their national sexual assault hotline on 800-656-4673. They treat all information anonymously and confidentially.

What to tell your doctor before an STI test

When requesting STI testing or attending a routine checkup, it’s helpful to let your doctor know:

  • which forms of contraception you use
  • medications you take on a regular basis, if any
  • any potential exposures to an STI you may be aware of
  • whether your relationship is monogamous and how many other sexual partners you or your partner have had
  • whether you are pregnant, as some STIs can cause fetal anomalies during pregnancy
  • whether you regularly engage or have engaged in anal sex, as many standard STI tests can’t identify anal STIs

Where can you receive testing?

STI tests take place in several settings, including:

  • Doctor’s office. Your physician or a healthcare professional at an office or emergency room can request rapid STI testing for you.
  • Government-funded healthcare clinics. Many of your local government-led health services offer STI testing for HIV, gonorrhea, chlamydia, and syphilis. Some might also test for herpes, hepatitis, and trichomoniasis.
  • Planned Parenthood. This nonprofit offers STI testing at varied prices, depending on your income, demographic, and eligibility for assistance.
  • Some pharmacies. You might be able to arrange testing for chlamydia, HIV, syphilis, and gonorrhea at your local pharmacy.
  • Home testing. At present, the Food and Drug Administration (FDA) has only approved one kit for home STI testing — the OraQuick In-Home HIV Test. If you don’t live in the United States, there are other options for home testing, such as LetsGetChecked, Everlywell, Nurx, and STD Check.

The law may require your physician to share your diagnosis.

Certain STIs are notifiable diseases. This means that your physician will need to let the government know that you’ve tested positive for that STI. These include:

  • chlamydia
  • gonorrhea
  • hepatitis
  • HIV
  • syphilis
  • chancroid

What types of STI tests are there?

A healthcare professional will carry out an STI test in one of several ways. Once you’ve informed your healthcare professional about any changes to your genitals or anus, they may recommend one of the following:

  • Swabs. A healthcare professional inserts a cotton applicator into your urethra to collect cells from part of your reproductive system. Many doctors test for STIs using cervical, vaginal, or urethral swabs. For those who practice anal sex, a doctor can also take an anal swab.
  • Blood and urine tests. Chlamydia, gonorrhea, HIV, and syphilis might show up in a test of your blood or urine. However, these may be inaccurate and might not show infectious organisms that you acquired less than 2 weeks to several months ago.
  • Physical examination. Conditions like genital warts and herpes produce skin symptoms around your genitals and anus. A healthcare professional may check any unusual lumps, rashes, or lesions to determine whether an STI is the underlying cause. They may also request a swab or blood/urine test to confirm the diagnosis.

To see more answers to common questions about STIs, click here.

What is blue waffle disease?

It is a fictional STI that spread around the internet as a hoax. Proponents claimed it could give the vagina a blue tint and cause disfigurement.

How can I get blue waffle disease?

You can’t because it’s not real.

How do I know I have blue waffle disease?

You can be sure you don’t, as it’s completely fictional.

Don’t dismiss all physical changes to your genitals, though, because they could be symptoms of a real STI. Redness and irritation alongside itching and discharge with an odor might be a result of vaginitis.

Several STIs can lead to vaginitis, including chlamydia, gonorrhea, and trichomoniasis.