Sexually transmitted diseases (STDs) remain a major global health concern, affecting millions of people and causing not only physical symptoms but also emotional and economic hardship. While significant progress has been made in diagnosis, treatment, and prevention, STDs continue to spread due to challenges like antimicrobial resistance, overlooked non-sexual transmission routes, and gaps in our understanding of their broader context. This narrative review explores current research with a fresh, interdisciplinary lens bringing together insights from microbiology, new diagnostic technologies, and cultural perspectives. It highlights critical issues, including rising resistance in lesser-known pathogens, the role of the genital microbiome in infection risk and recovery, and how environmental and societal factors shape disease patterns. The review also examines innovative solutions like point-of-care testing, targeted prevention strategies, and emerging ideas such as microbiome-based therapies, climate-aware health policies, and personalisedtreatments guided by genomics. By integrating these diverse approaches and embracing global collaboration, we can move toward more effective, inclusive, and forward-thinking strategies for tackling STDs and promoting better sexual health for all. © 2025 Elsevier B.V., All rights reserved.