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Chlamydia is one of the most common sexually transmitted diseases. These infections also referred to as STDs, STIs, or venereal disease, are primarily spread through genital or bodily fluids contact. They are also caused by viruses, bacteria, and parasites.

Chlamydia trachomatis bacteria is the cause of chlamydia and can be transmitted through vaginal, anal, or oral sex.

Often, people with chlamydia may not realize they are infected because they don’t experience any symptoms like genital pain and vaginal or penile discharge. Although chlamydia trachomatis mainly affects younger women, it can also occur in men and women of all ages.

Chlamydia is an easily treatable condition. However, it could cause more severe health complications if left untreated.

By Able Health I Medically reviewed by Dr. Alireza Estedlal

Page last reviewed: February 2024 I Next review due: February 2026

Understanding chlamydia: What is it and how does it spread?

Chlamydia is a bacterial infection often caused by bacterium Chlamydia trachomatis. It may be contracted through sexual contact, including oral, vaginal, or anal sex with an infected person. The bacteria can infect the urethra, cervix, rectum, or throat. On the other hand, it should be noted that chlamydia might still be transmittable despite the absence of noticeable signs and symptoms.

A number of risk factors increase the chances of acquiring chlamydia infection. Examples are having several sexual partners, being sexually active at an early age, unprotected sexual intercourse, and a history of STIs. Furthermore, persons who don’t constantly or properly use condoms have higher risks of contracting the infection.

What are the Symptoms of Chlamydia?

Typically, Chlamydia trachomatis infections cause a few symptoms during the early stages. These symptoms are usually mild when they do occur and, hence, can easily be ignored. Regular screening is thus important to ensure early detection and prevent other serious problems.

The symptoms of Chlamydia trachomatis infections are:

  • Pain when urinating
  • Vaginal discharge
  • Abnormal discharge from the penis
  • Painful vaginal sex
  • Vaginal bleeding after intercourse and between periods
  • Pain in the testicles

Based on the sexual activity of an individual, Chlamydia trachomatis can also infect the following areas:

  • Eyes: Infections of the eye (conjunctivitis) cause reddening and irritation inside the eyelid.
  • Throat: An infection of the throat may cause a soreness or may not have any symptoms.
  • Rectum: An infection of the rectum may cause pain, bleeding, discharge, or no symptoms at all.

Causes of Chlamydia

Chlamydia trachomatis bacterium is mostly transmitted through vaginal, oral, or anal sex. In some cases, the bacterium can also spread from the mother to the baby during childbirth. This could cause pneumonia or severe eye infection in the infant.

Importance of early detection and diagnosis of chlamydia

For individuals who have chlamydia symptoms, the Centres for Disease Control and Prevention (CDC) advises immediate testing for the infection. Moreover, discussing with your medical provider how frequently you should undergo screening for chlamydia, irrespective of the symptoms, is crucial. Generally, certain groups require more regular screening compared to others. They include:

  • Sexually active women aged 25 or below: Since this group has the highest rate of infection, an annual chlamydia screening test is required. You should also be screened whenever you have a new sexual partner, regardless of whether your previous test is less than a year.
  • Pregnant women: Screening for the infection may be done during the initial prenatal exam. However, for individuals at a greater risk of chlamydia, getting another test later on during the pregnancy is important. Pregnant women at high risk include those with new sex partners or infected sex partners and those below 25 years.
  • High-risk individuals: Those with new or more than one sexual partner and men who engage in sexual intercourse with fellow men should undergo more regular screening. Also, people currently infected with another STI and those possibly exposed through an infected partner are additional indicators of high-risk cases.

Screening and Diagnosis

Chlamydia infection screening and diagnosis involves quite simple tests, including:

  • Urine test: This test analyses urine samples for the presence of chlamydia infection in the lab. The procedure is suitable for both genders.
  • A swab: With this test, a sample from the vagina, cervix, anus, or throat is collected using a swab for examination. For vaginal swabs, either you or your medical provider can perform the swab. On the other hand, for the cervix, the doctor can collect the discharge sample with a swab during a regular pap smear. Based on sexual history, anus and throat swabs may be necessary for both men and women.

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Treating and Managing Chlamydia

If you suspect chlamydia, your medical provider can test you, or you can alternatively use any accessible test without a prescription. Also, consider retesting in three months if you have had treatment for an initial infection.

Antibiotics can help clear chlamydia infection within one or two weeks. However, you should ensure that you finish the full course of medication even if the symptoms get better. Most importantly, consult with your physician about any necessary follow-up after completing your prescription. This is to ensure the infection is cleared and to prevent recurrence.

The chlamydia treatment plan should include measures like avoiding intercourse that could cause reinfection and ensuring your potentially infected sexual partner receives treatment. You should also practice the following:

  • Abstaining from sexual activities until your infection clears: You are not completely out of the woods after starting your treatment. Therefore, ensure that you take all your medicines as instructed, and meanwhile, refrain from all sexual contact.
  • Talk with your sexual partners: You should inform all your sexual partners, especially from the past three months, concerning your condition so they can be tested.
  • Testing for other STIs: Since having multiple STIs is usually common, it is crucial to get tested for other infections such as syphilis, gonorrhea, HIV/AIDS, or herpes to receive the appropriate treatment.

While antibiotics can eliminate your chlamydia infection, they cannot reverse any damage in the body caused by bacteria. Because of this, regular screening, visiting your doctor as soon as you notice symptoms, and immediate treatment if infected are very important.

What could happen if chlamydia isn’t treated?

If not treated, chlamydia can pose various health risks. So, if you suspect chlamydia symptoms, schedule an appointment with your doctor right away. Also, routine STI screening should be considered to prevent future complications.

Chlamydia complications in women

If left untreated, chlamydia could cause the following complications in women and people assigned female at birth (AFAB):

  • Pelvic inflammatory disease (PID): PID is a severe condition that may require hospitalization. It can develop if untreated STI, such as chlamydia, causes damage to the reproductive organs, leading to chronic pelvic pain and infertility. This disorder can also block the fallopian tubes, resulting in ectopic pregnancy, which poses fatal risks for the fetus and the mother or even the gestational parent.
  • Pregnancy complications: Chlamydia that is not treated can result in pre-term delivery. A pregnant woman with the infection can also infect a newborn, leading to pneumonia or conjunctivitis, which may cause blindness if untreated. Testing or screening for chlamydia during the first prenatal visit is thus essential for expectant mothers to avoid such complications.
  • Infertility: Chlamydia can lead to permanent uterus, fallopian tubes, or vaginal damage if left untreated. This makes it generally difficult to get pregnant.

Chlamydia complications in men

Untreated chlamydia in men and those assigned male at birth (AMAB) can cause complications such as:

  • Epididymitis: This condition occurs when the chlamydia infection spreads to the testicles and epididymis (the tube carrying sperm to the testicles). This can cause testicular symptoms such as pain, swelling, or tenderness.
  • Reduced fertility: The infection can damage the sperm, and this could negatively affect one’s fertility.

Chlamydia complications that can affect everyone

If left untreated, chlamydia infection could spread to the bloodstream, increasing the risks of these conditions:

  • Reactive arthritis; a condition that causes pain and swelling of the joints.
  • HIV infection

How soon will you feel better after treatment?

Once you start taking medications, you should feel better in a week. However, ensure that you finish your antibiotics prescription even if the symptoms are improving.

How long after starting your treatment should you wait to have sex?

Avoid any sexual activities (vaginal, oral, or anal) with anyone for at least 7 days after starting treatment. This allows the antibiotics to work effectively and prevent you from infecting your partners. Also, after treatment, continue practicing safe intercourse and consider STI testing as part of your routine health care.

Preventing Chlamydia Infection

The best-guaranteed way of preventing chlamydia infection is abstaining from sexual activities. Alternatively, you can consider other preventive measures like:

  • Using condoms: Always wear a male latex or female polyurethane condom in every sexual contact. When properly and consistently used, condoms reduce the possibility of contracting an infection but won’t eliminate the risk.
  • Limiting the number of your sexual partners: Generally, having several sex partners increases the risks of getting chlamydia and other STIs.
  • Getting regular screenings: Discuss with your medical provider regarding the frequency of chlamydia and other STI screenings, especially if you are sexually active and have more than one partner.

What is The Connection between Chlamydia and Infertility?

Chlamydia infection that is not treated on time can result in serious fertility problems. In females, untreated chlamydia can cause PID, which damages the reproductive organs and leads to scarring. This can block the tubes, hindering the egg from getting to the uterus and increasing the possibility of having an ectopic pregnancy.

On the other hand, untreated chlamydia in males can lead to epididymitis, an inflammation of the sperm-carrying tube (epididymis). This could cause infertility or a lower fertility rate.

Early diagnosis and treatment are thus important to maintain fertility and avoid permanent complications.

Chlamydia and Pregnancy: Risks and Precautions

During pregnancy, chlamydia can put the mother and the child at risk. In most cases, untreated chlamydia infection can increase the possibility of low birth weight, premature birth, and neonatal pneumonia in infants. In addition, it could cause complications like miscarriage and stillbirth.

For that reason, chlamydia screening early in pregnancy should be done, particularly for women with multiple sex partners or those who have unprotected intercourse. Antibiotic treatment during pregnancy can be recommended since it is safe and can prevent complications.

Chlamydia in Adolescents and Young Adults: Risks and Prevention

Teenagers and young adults are at a high risk of contracting chlamydia because of factors like increased sexual activities, STI unawareness, and inconsistent protection use. Approximately 50% of all new cases of chlamydia occur in persons between the ages of 15 to 24.

Sexual education and preventive initiatives focused on young individuals are thus essential in reducing chlamydia incidence. This involves encouraging safe sexual practices, offering comprehensive sex education in schools, and enhancing accessibility to testing and treatment facilities.

The Purpose of Safe Sex Practices in Chlamydia Prevention

In general, safe sexual practices are essential in the prevention of chlamydia infection transmission. The most effective approach to reducing the risk is correctly and consistently using condoms during sexual intercourse. Condoms lower the possibility of transmission by acting as a barrier that prevents the infected areas from coming into direct contact.

Additional safe sex practices are regular STI testing, limiting sexual partners, and having open conversations regarding sexual health with your partners. It is also crucial to note that chlamydia can be transmittable despite the absence of noticeable symptoms, hence the importance of constantly engaging in safe sex.

Chlamydia and STI Co-Infection

Chlamydia frequently coexists with other STIs, including syphilis or gonorrhea. Mostly, multiple STI co-infections can make treatment difficult and increase complication risks. Therefore, if you suspect an infection or have a new sexual partner, you should consider getting screened for multiple STIs.

Treatment options for co-infection can include a combination of antibiotics in order to successfully target all existing infections. It’s also important to adhere to the prescribed treatment plan and finish the full course of medications to eliminate infections completely.

Does chlamydia infection have a smell?

Not all cases of chlamydia have an odor. However, unusual vaginal discharge with a foul smell is one of chlamydia symptoms.

How did I get chlamydia if I did not cheat?

You can contract chlamydia infection if your partner had sexual intercourse with an infected person and then had sex with you. Individuals in relationships might have varying thoughts on what constitutes ‘cheating’ in terms of sexual contact, and this misconception could result in infections.

Be open and honest with your partner regarding the kind of sexual activities you are having and what they are engaging in as well. Most importantly, practice safe sex to lower your chances of contracting chlamydia infection and get regular screening.

How did I get chlamydia if my partner is not infected?

Chlamydia symptoms may take weeks, months, or even years to appear. Sometimes, you may have no noticeable symptoms and are unaware that you have the infection. This implies that you might have contracted chlamydia from your past sex partners. It’s therefore recommended to get tested if you’ve had unprotected sex with multiple partners.