Chlamydia – Prevalence – Symptoms – Complications – Diagnosis and Treatment

What is chlamydia? (see references page)

  • Chlamydia is the most frequently reported sexually transmitted disease (STD).
  • It is caused by the bacteria Chlamydia trachomatis.
  • Women can be reinfected after treatment if their sex partners are not treated. Reinfections place women at higher risk for serious reproductive health complications, including infertility.
  • Many people who are at risk of chlamydia infection don?t know what it is, or understand it, even if they are aware of the name.

How common is Chlamydia infection?Chlamydia and age

In the U.S. an estimated 2.8 million Americans get chlamydia each year. Chlamydia is the most common STI in the UK. It affects both sexes, although young women are more at risk.

Chalmydia is more common in early reproductive years.

How do you get chlamydia?

  • Sexually active women and men can get chlamydia through sexual contact with an infected person. The more sex partners a person has, the greater the risk of getting infected with chlamydia.
  • Chlamydia can be passed during vaginal, anal, or oral sex.
  • As there are often no symptoms, people who are infected may unknowingly pass chlamydia to their sex partners.
  • An infected mother can also pass chlamydia to her baby during childbirth. Babies born to infected mothers can get pneumonia or infections in their eyes, also called conjunctivitis. Blindness may ensue.
  • Chlamydia can easily confused with gonorrhea, another STD. Gonorrhea and chlamydia have similar symptoms and can have similar complications if not treated, but these two STDs have different treatments.

What are the symptoms of chlamydia?

Chlamydia is known as a “silent” disease because 75 percent of infected women and at least half of infected men have no symptoms. Infection may only be diagnosed once chlamydia has led to complications – when treatment can sometimes be too late to stop permanent damage. If symptoms do occur, they usually appear within 1 to 3 weeks of exposure. The infection first attacks the cervix and urethra.

Early symptoms can include:

  • an abnormal vaginal discharge
  • dysuria, a burning sensation when urinating. Even if the infection ascends from the cervix to the uterus and fallopian tubes, some women may still have no signs or symptoms.

Later symptoms can include:

  • lower abdominal pain
  • low back pain
  • nausea
  • fever
  • dyspareunia (pain during sex)
  • inter-menstrual bleeding – bleeding between menstrual periods
  • post-coital bleeding
  • Infertility. Chlamydia is the most common preventable cause of infertility in women. When the Fallopian tubes are blocked, no pregnancy is possible naturally. One option is IVF (in-vitro fertilisation), but availability on the NHS is patchy and has variable success rates.

As symptoms do not always occur, the infection is often not diagnosed or treated until complications have occurred. If you go to a GP or family planning doctor with these symptoms, make sure you have a chlamydia test. You are entitled to ask for the chlamydia test if you aren’t offered it.

Men with symptoms might have a discharge from the penis and a burning sensation when urinating. Men might also have burning and itching around the opening of the penis or pain and swelling in the testicles, or both. The bacteria also can infect the throat from oral sexual contact with an infected partner.

What health problems can result from untreated chlamydia?

If untreated, chlamydia infection can cause serious reproductive and other health problems. Like the disease itself, the damage that chlamydia causes is often “silent.” As chlamydia is a sexually transmitted disease, those who are at risk may develop other infections such as gonorrhea, syphilis and HIV/AIDS.

In women, the chlamydia bacteria often infect the cells of the cervix. If not treated, the infection can spread into the uterus, fallopian tubes, and ovaries and cause pelvic inflammatory disease (PID). This happens in up to 40 percent of women with untreated chlamydia. PID can cause:

  • Infertility. This is the inability to get pregnant. The infection causes inflammation of the fallopian tubes, which become blocked, keeping eggs from being fertilized.
  • Chlamydia infection can affect sperm function and male fertility. It is the most common cause of inflammation in the testicles and sperm-conducting tubes (epididymo-orchitis) in men under the age of 35. This causes pain, swelling and redness on the affected side of the scrotum, or on both sides.
  • An ectopic or tubal pregnancy. This means that a fertilized egg starts developing in the fallopian tube instead of moving into the uterus. This is a dangerous condition that can be potentially lethal.
  • Chronic pelvic pain.

Untreated chlamydial infections can also cause inflammation of the bladder. In men having anal sex with a partner who has chlamydia, the bacteria can cause proctitis, which is an infection of the lining of the rectum. Untreated chlamydia in men typically causes infection of the urethra, the tube that carries urine from the body. Infection sometimes spreads to the tube that carries sperm from the testis. This may cause pain, fever, and even infertility.

In pregnant women, chlamydia infections may lead to premature delivery. Babies born to infected mothers can get infections in their eyes, called conjunctivitis or pinkeye, as well as pneumonia. Symptoms of conjunctivitis include discharge from the eyes and swollen eyelids, usually showing up within the first 10 days of life. Symptoms of pneumonia are a cough that steadily gets worse and congestion, usually showing up within three to six weeks of birth. Both of these health problems can be treated with antibiotics.

How is chlamydia diagnosed?

Only a doctor or nurse can diagnose chlamydia. There are laboratory tests to diagnose chlamydia. Some tests involve getting a sample from an infected site (cervix or penis) to be tested for the bacteria. Blood tests for chlamydia may show antibodies indicating past infection. A Pap test is not a test for chlamydia.

Who should get tested for chlamydia?

Women should consider having a test for chlamydia if they:

  • Have new or multiple sex partners
  • Have sex with someone who has other sex partners
  • Do not use condoms during sexual activity within a relationship that is not mutually monogamous, meaning their sex partners have sex with other people
  • If you have unusual vaginal discharge, burning with urination, or other symptoms listed above, and you are at risk of sexually transmitted disease

What is the treatment for chlamydia?

If you think you have chlamydia or are concerned about it, both you and your sex partner should see a doctor. Antibiotics are used to treat and cure chlamydia. It is one of the more common of the sexually transmitted diseases. Chlamydia are sensitive to antibiotics including erythromycin and the tetracyclines. A single dose ofazithromycin or a week of doxycycline are the most commonly used treatments. All sex partners should also be treated to avoid reinfection. You should not have sex until you and your sex partner(s) have finished treatment. Erythromycin is a safe antibiotic to cure chlamydia during pregnancy.

What should I do if I have chlamydia?

Chlamydia is easily treated, but it?s important for you to seek testing as soon as you think you could be at risk. By seeking testing and getting treated, you are taking good care of your reproductive health. If you have chlamydia:

  • Get it treated right away. Visit a clinic, doctor, or nurse.
  • Follow your doctor?s orders and finish all the medicine that you are given. Even if the symptoms go away, you still need to finish all of the medicine.
  • Avoid having any sexual activity while you are being treated for chlamydia.
  • Tell your sexual partners, so they can be treated too.
  • Get a follow-up test three to four months after treatment to make sure that the infection has not recured.
  • See your doctor again if your symptoms do not disappear within one to two weeks after finishing the medicine.
  • See your doctor again within 3 to 4 months for another chlamydia test, especially if your sex partner was not treated or if you have a new sex partner.

Doctors, local health departments, and STD and family planning clinics have information about STDs and can give you a test to find out if you have chlamydia. Don?t assume your doctor will automatically test you for chlamydia ? you can take care of yourself, though, by asking about chlamydia and re questing a test.

How can chlamydia be prevented?

There are things you can do to lower your risk for getting chlamydia:

  • Don?t have sex. The best way to prevent chlamydia or any STD is to practice abstinence, or not having vaginal, anal, or oral sex.
  • Be faithful. Have a sexual relationship with one partner who has been tested for chlamydia and is not infected is another way to reduce your chances of getting infected. Be faithful to each other, meaning that you only have sex with each other and no one else.
  • Use condoms. Condoms can lower the risk of passing chlamydia, so protect yourself with a condom EVERY time you have vaginal, anal, or oral sex. Condoms should be used for any type of sex with every partner. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a dental dam. A dental dam is a rubbery material that can be placed over the anus or the vagina before sexual contact.
  • Know that some methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STDs. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sex.
  • Learn the symptoms of chlamydia. But remember that chlamydia often has no symptoms. Seek medical help right away if you think you may have chlamydia or another STD.