Chlamydia: symptoms, treatment & prevention

Chlamydia is one of the most commonly reported bacterial sexually transmitted diseases (STDs). It is caused by the Chlamydia trachomatis bacterium, which may infect the urethra and rectum in both sexes and the cervix in women. Occasionally chlamydia can also affect other parts of the body, including the throat, lungs, liver and eyes.

Global chlamydia statistics show that an estimated 92 million new chlamydia infections occur each year, affecting more women (50 million) than men (42 million). Chlamydia can cause serious problems later in life if left untreated.

Chlamydia symptoms and signs

Symptoms usually appear between 1 and 3 weeks after exposure but may not emerge until much later. Chlamydia is known as the ‘silent’ disease as in many people it produces no symptoms. It is estimated that 70-75% of women infected with chlamydia are asymptomatic (have no symptoms) and a significant proportion of men also have no symptoms. Those who do have symptoms may experience:

• Women

• a minor increase in vaginal discharge caused by an inflamed cervix.
• cystitis (an inflammation of the lining of the bladder).
• the need to urinate more frequently, or pain whilst passing urine.
• pain during sexual intercourse or bleeding after sex.
• mild lower abdominal pains.
• irregular menstrual bleeding.
• a painful swelling and irritation in the eyes (if they become infected).

• Men

• Men are more likely to notice symptoms than women, though they too may be asymptomatic.
• a white/cloudy and watery discharge from the penis that may stain underwear.
• a burning sensation and/or pain when passing urine.
• a painful swelling and irritation in the eyes (if they become infected).

In both men and women a chlamydia infection in the rectum will rarely cause symptoms.

How is chlamydia passed on?

Chlamydia can be transmitted:

• by having unprotected vaginal, anal or oral sex with someone who is infected.
• from a mother to her baby during vaginal childbirth.
• by transferring the infection on fingers from the genitals to the eyes, although it is rare for this to happen.

Where to go for help

If you have any symptoms or you are worried you may have been infected with chlamydia, you should discuss your worries with a doctor. They may be able to run tests or offer you treatment themselves, or else will refer you to someone who can.

In some countries, local pharmacies and chemists may offer chlamydia testing kits that allow a person to take a sample themselves for analysis by the pharmacy.

Some countries also have specific sexual health clinics that can help you directly. Check our help and advice page or your local telephone directory to see if you have a clinic near you.

The diagnosis of chlamydia

To find out if someone has chlamydia, a doctor or nurse will usually carry out the following examinations and tests:

• an examination will be done of a patient’s genital area.
• a urine sample may be taken.
• samples will be taken from any possibly infected areas, using a cotton wool or spongy swab.
• women will usually be given an internal pelvic examination, similar to a smear test, where a swab sample is taken from the cervix.
• men will be given an external examination of their testicles to check that these are healthy.

The examinations may be uncomfortable but they are unlikely to cause any pain.

Chlamydia will be detectable a few days after being infected, often before any symptoms have appeared.

Samples taken during the examinations are sent to a laboratory for testing. The result is usually available within one week, though this may vary depending on location.

Treatment of chlamydia

The treatment of chlamydia is simple and effective once the infection has been diagnosed, consisting of a short course of antibiotic tablets.

If a patient is allergic to any antibiotics, or if there is any possibility that they may be pregnant, it is important that the doctor is informed as this may affect which antibiotics are prescribed. Treatment must not be interrupted once a course of antibiotics has been started; otherwise it may be necessary to start again from the beginning.

The doctor or health advisor will discuss the chlamydia infection and answer any questions. They will also want to know about any partners the patient has had sexual contact with in the past six months, as they will also be at risk of having chlamydia and should be tested.

The infected patient should not have penetrative sex until treatment has finished and the doctor has confirmed they no longer have chlamydia by re-testing.

Follow-up

It is important that the patient returns for a check-up once the treatment has been completed to make sure they are well and have no recurring infection.

Complications

If chlamydia is left undiagnosed and untreated then it is more difficult to deal with. Early diagnosis and treatment means that chlamydial infection can be cleared up easily, but if it is left unchecked then other problems can arise.

• Women

• Pelvic Inflammatory Disease (PID) - an inflammation of the fallopian tubes (the tubes along which an egg passes to get to the womb). PID increases the future risk of ectopic pregnancy (a pregnancy outside the womb) or premature birth. If the fallopian tubes are scarred, it can also lead to problems with fertility. Female infertility can often be traced back to infection with chlamydia.
• Mother-to-child-transmission (MTCT) - during pregnancy chlamydia can potentially be passed on to the baby, giving it an eye or lung infection. Chlamydia can be safely treated during pregnancy provided the correct antibiotics are prescribed.
• Cervicitis - symptoms include a yellowish vaginal discharge and pain during sex. In long-term cervicitis the cervix becomes very inflammed and cysts can develop and become infected. This can lead to deep pelvic pain and backache.

• Men

• Complications caused by chlamydia in men are uncommon, but if left untreated a long-term infection may lead to:
• Epididymitis - painful inflammation of the tube system that is part of the testicles, which can lead to infertility.
• Urethritis - inflammation of the urine tube (urethra), causing a yellow or clear pus-like discharge to collect at the tip of the penis. Left untreated it can lead to a narrowing of the urethra, which can affect the ability to urinate easily and can potentially cause kidney problems.

• Men and women

• Complications that can occur in both sexes are:
• Reiters syndrome - can cause inflammation of the eyes and joints and sometimes a rash on the genitals and soles of the feet.
• Appendicitis (inflammation of the appendix).

Chlamydia prevention

Using condoms greatly reduces the risk of chlamydia being passed on during sex. Getting tested for STIs at a sexual health clinic, and encouraging new partners to get tested before having sexual intercourse, also helps to prevent transmission.

If you think you may have any of the symptoms listed above then getting tested is highly recommended. Visit the nearest G.U.M. (Genito-Urinary Medicine) clinic, sexual health clinic or doctor as soon as possible to avoid complications. In countries such as the USA and UK, all pregnant women are offered a test for STDs such as chlamydia, and it is recommended that all sexually active women under the age of 25 get screened for STDs at least once a year.