Most Prevalent Reproductive Disorders and Sexually Transmitted Infections (STIs) Affecting U.S. Women
One important clarification first: “reproductive and sexually related diseases” is broader than sexually transmitted infections (STIs). If we include reproductive disorders such as fibroids and endometriosis, they are substantially more prevalent among U.S. women than most STIs.
There is also no single federal ranking that puts all of these conditions into one dataset. So the most defensible approach is to rank them using the best available U.S. prevalence estimates, while clearly distinguishing lifetime prevalence, current/point prevalence, and annual incidence. I would not rank them by number of new cases alone, because that would produce a very different—and potentially misleading—list.
Chronological ranking: most prevalent first
| Rank | Disease/condition | Approximate U.S. burden in women | Type of measure | Why it ranks here |
|---|---|---|---|---|
| 1 | Uterine fibroids (leiomyomas) | ~70–80% by age 50; ~26 million women ages 15–50 in one U.S. estimate | Lifetime/cumulative prevalence | By far one of the most common reproductive disorders. Many are asymptomatic. |
| 2 | Vulvovaginal candidiasis (yeast infection) | ~75% of women have ≥1 episode; 40–45% have ≥2 | Lifetime prevalence | Extremely common vaginal condition, although it is not generally considered an STI. |
| 3 | Human papillomavirus (HPV) | ~38.4% of U.S. females ages 15–59 had HPV in 2018; ~19.2 million had a disease-associated HPV type | Point prevalence | By far the most prevalent sexually transmitted infection when measured as current infection. |
| 4 | Endometriosis | ~6.1% diagnosed prevalence in women 18–49 in a large U.S. study; roughly 6.5 million women of reproductive age are commonly estimated to be affected | Diagnosed prevalence | A major chronic reproductive disease associated with pelvic pain, painful sex and infertility. |
| 5 | Genital herpes (HSV-2) | ~12.2 million women ages 15–49 in the CDC's 2018 STI estimates | Point prevalence | One of the most common chronic STIs; many infections are undiagnosed. |
| 6 | Trichomoniasis | ~2.1 million women at a given time; U.S. female prevalence ~2.1% | Point prevalence | One of the most prevalent curable STIs in U.S. women. |
| 7 | Chlamydia | ~1.3 million women with prevalent infection in 2018 | Point prevalence | The most commonly reported bacterial STI in the U.S.; especially concentrated among younger women. |
| 8 | Pelvic inflammatory disease (PID) | ~2.5 million women ages 18–44 reported a lifetime diagnosis; 4.4% of sexually experienced women | Lifetime prevalence | Often develops as a complication of untreated chlamydia/gonorrhea and can cause infertility and ectopic pregnancy. |
| 9 | Gonorrhea | ~155,000 women with prevalent infection in the 2018 CDC estimate | Point prevalence | Much less prevalent than HPV, herpes, trichomoniasis or chlamydia, but U.S. incidence is substantial and has risen markedly over time. |
| 10 | Syphilis | ~38,000 women with prevalent infection in the 2018 estimate | Point prevalence | Less common than the infections above, but particularly important because of pregnancy/congenital complications. |
| 11 | HIV infection | ~208,000 women in the 2018 prevalence estimate | Point prevalence | Lower prevalence than most STIs, but substantial lifetime health consequences. |
| 12 | Gynecologic cancers — uterine, ovarian, cervical, vulvar and vaginal | Tens of thousands of new cases annually | Annual incidence | Much less prevalent than benign reproductive disorders and STIs, but among the most medically serious reproductive diseases. |
A major caveat about the ranking
The first two entries deserve special treatment.
Fibroids and yeast infections are so common that they overwhelm the STI numbers, but they are not directly comparable with an STI's point prevalence.
For example, saying that 75% of women experience a yeast infection sometime during life is not equivalent to saying 75% have an infection at a particular moment. Likewise, saying 70–80% of women develop fibroids by age 50 is a cumulative lifetime-type measure, not the percentage who currently have symptomatic fibroids.
If we instead restrict the question to sexually transmitted infections, the ranking becomes much clearer.
The STI ranking specifically
The CDC's comprehensive U.S. modeling study estimated 67.6 million prevalent STIs in 2018, with 26.2 million new infections that year. Importantly, four infections—HPV, genital herpes, trichomoniasis and chlamydia—accounted for approximately 97.6% of all prevalent STIs.
Among women:
1. HPV — ~19.2 million women with disease-associated HPV
HPV is the clear leader in terms of sexually transmitted infection burden. Among U.S. females ages 15–59, 38.4% had an HPV infection in 2018, while 19.9% had a disease-associated HPV type, corresponding to approximately 19.2 million women.
HPV is particularly important because persistent infection can lead to cervical, vaginal and vulvar cancers. CDC estimates that about 27,081 HPV-associated cancers occur annually among U.S. females, although not every one is caused by HPV.
2. Genital herpes (HSV-2) — ~12.2 million women
The 2018 CDC estimates put female HSV-2 prevalence at approximately 12.2 million women ages 15–49, versus about 6.35 million men.
Unlike chlamydia and gonorrhea, herpes is a chronic infection: once acquired, the virus remains in the body.
3. Trichomoniasis — ~2.1 million women
CDC estimates approximately 3.7 million people overall had trichomoniasis, with prevalence around 2.1% among females compared with 0.5% among males.
4. Chlamydia — ~1.3 million women
The CDC's 2018 model estimated approximately 1.306 million women had prevalent chlamydia infection.
Chlamydia is especially important in women because it is frequently asymptomatic. Untreated infection can ascend into the reproductive tract and contribute to PID, infertility and ectopic pregnancy.
5. Gonorrhea — ~155,000 women
The comparable 2018 prevalence estimate was approximately 155,000 women.
The number of new gonorrhea infections each year is much larger than the point-prevalence number, because treatment can cure the infection.
6. Syphilis — ~38,000 women
The estimated point prevalence among women was approximately 38,000 in 2018.
Its population prevalence is comparatively low, but its consequences during pregnancy make it disproportionately important.
7. HIV — ~208,000 women
The 2018 estimate was approximately 208,400 women living with HIV.
Reproductive diseases that aren't necessarily sexually transmitted
If your underlying question is “What diseases affecting the female reproductive/sexual system are women in America most likely to experience?”, then the picture changes considerably.
1. Uterine fibroids
This is arguably the biggest reproductive-disease burden in the U.S.
Research indicates that 70–80% of women develop fibroids by age 50, and an AHRQ analysis estimated approximately 26 million U.S. women ages 15–50 have them.
The important distinction is that most fibroids do not necessarily cause symptoms. Among women who do become symptomatic, heavy menstrual bleeding, pelvic pain/pressure, urinary symptoms and reproductive problems are common. Estimates suggest roughly 25–50% of women with fibroids become symptomatic.
2. Vulvovaginal candidiasis
CDC estimates that approximately 75% of women experience at least one episode of vaginal candidiasis during their lifetime and 40–45% experience two or more.
That makes yeast infection extraordinarily common—but again, it should not be classified as a conventional STI.
3. Endometriosis
A large U.S. survey of 48,020 women estimated diagnosed endometriosis prevalence at 6.1% among women ages 18–49.
Other U.S. estimates put the burden at approximately 6.5 million women of reproductive age.
It can cause severe menstrual/pelvic pain, pain with intercourse and infertility.
4. Pelvic inflammatory disease
PID is particularly important because it represents damage to the reproductive system resulting from infection, frequently involving chlamydia or gonorrhea.
CDC's nationally representative NHANES analysis found that 4.4% of sexually experienced U.S. women ages 18–44—approximately 2.5 million women—reported a lifetime diagnosis of PID.
CDC currently states that about 1 in 8 women with a history of PID has difficulty becoming pregnant.
One particularly important distinction: prevalence ≠ danger
If you are trying to understand which conditions affect women the most, I would use this hierarchy:
By sheer prevalence
- Uterine fibroids
- Vulvovaginal candidiasis
- HPV
- Endometriosis
- Genital herpes
- Trichomoniasis
- Chlamydia
- PID
- Gonorrhea
- HIV/syphilis and gynecologic cancers, depending on whether you use point prevalence, annual incidence, or lifetime risk
But by medical seriousness, the order changes dramatically. A disease such as ovarian cancer is vastly less prevalent than fibroids but has much greater mortality risk. CDC identifies uterine cancer as the most common gynecologic cancer in the U.S., while ovarian cancer is the second most common and the deadliest gynecologic cancer.
Similarly, HPV is often transient and clears spontaneously, while a relatively uncommon persistent HPV infection can eventually cause cervical cancer. CDC estimates approximately 13,000 new cervical cancer cases and 4,000 deaths annually in the U.S.
Bottom line
If by “affect women the most” you mean how many women experience the condition, the biggest burdens are fibroids, vaginal candidiasis, HPV, endometriosis and genital herpes.
If you mean sexually transmitted diseases specifically, the best-supported prevalence order is:
HPV → genital herpes → trichomoniasis → chlamydia → gonorrhea → HIV/syphilis, with HPV overwhelmingly the most prevalent. The CDC's national analysis found that HPV, herpes, trichomoniasis and chlamydia together constituted roughly 98% of prevalent STIs in the United States.
One final methodological caution: the CDC's most comprehensive all-STI prevalence estimates are based on 2018 data, because prevalence of several infections cannot be measured through routine case reporting. CDC's newer surveillance data are excellent for reported incidence, particularly chlamydia, gonorrhea and syphilis, but reported cases are not equivalent to true prevalence because many infections—especially in women—are asymptomatic and never diagnosed.
