What is Chlamydia?
Chlamydia is a sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis. It is one of the commonest STIs and is on the increase. Chlamydia infection often causes no symptoms and may remain undiagnosed until complications occur.
Chlamydia is usually spread through sexual intercourse but it can also be passed by other intimate contact with the genital or rectal area.
How would I know if I had Chlamydia?
You may not have any symptoms so it is important that you get checked out if you have had unprotected intercourse with a new partner.
Some women may have non-specific symptoms such as cystitis, change in vaginal discharge and mild lower abdominal pain.
Chlamydia affects the cervix causing cervicitis (inflammation of the cervix) and can spread upwards to involve the fallopian tubes (salpingitis), and the womb.
Symptoms include:
New/unusual vaginal discharge, may be yellow (contains pus).
Urinary symptoms, such as frequency and a burning pain on urination may occur.
Pain on intercourse.
Chronic chlamydia infection causes the cervix to become swollen and enlarged. The cervix may contain cysts that may also become infected. There may be:
Left untreated, the infection can spread to the womb and tubes causing pelvic inflammatory disease. Blockage of the fallopian tubes can occur causing infertility. Partial blockage increases the risk of pregnancy in the tube (ectopic pregnancy).
In men, chlamydia can affect:
The urethra (the tube that passes through the middle of the penis) causing urethritis (inflammation of the urethra)
The epididymis (tubular part of the testicle) causing epididymitis
The prostate gland, causing prostatitis
Again, there may be no symptoms but the following may occur:
Urethral discharge (yellow pus or clear mucus)
Pain or discomfort on passing urine
Hot, tender swelling of the testicle due to inflammation of the testis (epididymitis), which can result in sterility
Pain during or after intercourse
Lower back pain
Anal chlamydial infection can cause anal irritation and pain during a bowel movement.
Chlamydia can also cause Reiter’s syndrome (inflammatory arthritis, urethritis and eye inflammation) about three weeks after Chlamydia infection.
Where can I go for a test?
Most people visit their local STI or Genito-Urinary Medicine Clinic. You usually need to phone for an appointment first but you do not need to be referred by your doctor. Your GP may also be able to do the tests.
You will be asked about your symptoms and examined. Chlamydia is usually diagnosed by special swab tests or a specialised urine test.
In women, a cervical swab is taken. This is somewhat similar to having a smear test done. A speculum is used to view the cervix and a swab is then taken from the cervix using a special cotton wool bud.
In men, the specimen is taken from the opening of the urethra using a special slim swab.
A specialised urine test can also be done. However, this test is not available everywhere, and in women it is not as reliable as taking a sample from the cervix.
Swabs may be taken from the anus if you have had anal sex or are having symptoms in that area.
Usually, tests are also taken for other STIs.
Sometimes treatment will be commenced before the test results are available.
Results of these tests will also indicate which antibiotic is most suitable for treatment.
Early diagnosis and treatment of Chlamydia will reduce the risk of complications, so the earlier you get checked out, the better.
What if the test is positive?
If you test positive for Chlamydia, antibiotic treatment will be commenced (if not already started). Chlamydia infection usually responds very well to antibiotics; sometimes the infection can be treated with a single dose.
The symptoms of urethritis are usually gone within a few days of taking the antibiotic. However, it is very important that you finish the course of treatment even if your symptoms have settled.
Epididymitis (inflammation of the epididymis of the testicle) and prostatitis (inflammation of the prostate gland) take longer to treat. Prostate infections may need two to four weeks of treatment.
If your symptoms do not settle, or if they return after you have finished treatment, you should see the doctor again.
You may need to take more than one antibiotic, especially if there is a chance you have other infections, such as gonorrhoea.
Sexual partners also need treatment, even if they have no symptoms.
You will be asked to return for repeat testing to make sure the infection has cleared up.
Are there any long-term effects?
In women, Chlamydia infection:
Is one of the principal causes of Pelvic Inflammatory Disease (PID), which can lead to infertility, chronic pain and an increased risk of ectopic pregnancy and miscarriage.
Chlamydia can pass from a mother to baby during childbirth. This can cause a severe eye infection (ophthalmia neonatorum) or lung infection (pneumonitis).
In men, Chlamydia infection can cause:
Sterility or impaired fertility as a result of epididymitis.
A urethral stricture (a localised narrowing of the urethra) as a result of urethritis.
Urethral stricture can interfere with the outflow of urine, causing back-pressure effects, which can damage the kidneys.
Reiter’s Syndrome, an inflammatory arthritis, which occurs one to three weeks after a chlamydial infection. Reiter’s disease is the commonest cause of arthritis in young men and occurs in about 2% of men with urethritis.
How can Chlamydia be prevented?
Practice safe sex. Condoms are the only method of contraception that will protect against STIs so if you are with a new partner always use a condom, even if you are using another method of birth control such as the pill.
Have just one sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for Chlamydia and other STIs.
Sexual partners who have been exposed to Chlamydia should be notified so that they can get tested.
Even if you don't have symptoms but have had unprotected sex (without a condom), you need to be tested for STIs.
Written by Medpages Editorial Team
Last Editorial Review: 21/1/2010
