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Pelvic inflammatory disease

PID diagnosis and management

Chlamydia
Essential facts

Chlamydia is an infection of the reproductive organs caused by the bacterium Chlamydia trachomatis. It is a very common condition and there are no clear risk factors. It often occurs in young adults; simply changing sexual partners can put anyone at risk.

If chlamydia is not diagnosed soon after infection, complications may occur in both women and men. Fortunately, it can be simply and effectively treated.

Symptoms

Most people with chlamydia do not have any symptoms and are unaware they have the infection. Chlamydia can be detected by a test at an STD check-up.

Symptoms that may occur:

• In males, chlamydia may cause urethritis, which can produce a discharge from the penis or pain when urinating. If not treated, it can lead to inflammation near the testes, which can cause considerable pain, and may lead to infertility.

• In females, infection often starts in the cervix. Symptoms such as a vaginal discharge, burning when passing urine, lower abdominal pain, or pain during sexual intercourse may occur. If chlamydia is not treated, it may spread through the uterus to the fallopian tubes, causing salpingitis, a painful condition which may result in infertility or ectopic pregnancy (where the pregnancy develops outside the uterus. This is potentially a life threatening condition.) In some cases, infection of the whole reproductive system — pelvic inflammatory disease (PID) — can occur.

• In both sexes, infection may be present in either the throat or the rectum (anus). At either of these sites there are usually no symptoms.

Transmission

Chlamydia is sexually transmitted, usually through vaginal intercourse. Occasionally it is transmitted by oral sex or anal sex.

Chlamydia can be passed from mother to child during birth, causing eye infections (conjunctivitis) or pneumonia.

Diagnosis

Chlamydia is best diagnosed from swab tests, collected from the cervix in women or the urethra in men. Swabs can also be taken from the throat or rectum if there is a possibility of infection there.

A urine test can be used to screen men for chlamydia if they have no symptoms of the infection. This test is not as sensitive as a swab test and is not recommended for women.

Chlamydia cannot be diagnosed from a blood test.

Treatment

Chlamydia can be treated with antibiotics such as azithromycin (Zithromax) or doxycycline (Doryx).

Further sex

Do not have sex while taking the tablets, or for one week after treatment with azithromycin. There may still be a risk of transmitting the infection to sexual partners during this time.

For men, symptoms such as discharge, stinging or irritation will settle down much more quickly if you do not have sex (vaginal, oral or anal), masturbate, squeeze or milk the penis.

Follow-up

Sexual partner(s) should be tested for chlamydia, even if they have no symptoms.

If you have been diagnosed with chlamydia, you should have a blood test in three months to detect blood-borne infections you might have contracted at the time you had chlamydia.

Prevention

Use a condom. A condom worn during intercourse provides good protection against chlamydia infection.

Have an STD check-up, including a chlamydia test:

• after sex with a new or casual partner
• immediately if symptoms occur, e.g. discharge, pain when passing urine
• if a sexual partner has chlamydia or symptoms of chlamydia.

Remember, most people with chlamydia do not know they are infected and continue to have sex. Practising safe sex and being checked regularly for chlamydia, especially if you change partners, are the most effective ways of protecting yourself.

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