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Chlamydia

Chlamydia

Chlamydia’s most dangerous characteristic is that most women — about 75 percent — don’t know they have it until they develop a much more serious illness called pelvic inflammatory disease, or PID.

What is chlamydia?

It’s a sexually transmitted disease that has recently (and sneakily) assumed the status of an epidemic. Chlamydia is easily cured, but it’s both hard to detect and dangerous because it usually causes no symptoms until it has established a serious, even life-threatening, infection. Today it’s the most frequently reported sexually transmitted disease in the United States, where it is believed to strike almost 2.3 million people per year. The bacterium Chlamydia trachomatis is spread through vaginal, oral, or anal sex.

What are the symptoms?

Medical researchers named chlamydia for the Greek word meaning “cloak,” precisely because it’s not usually accompanied by any symptoms. Only one in four women infected with the chlamydia bacterium have identifiable symptoms, and only about one in two men.

Chlamydia’s most dangerous characteristic is that most women — about 75 percent — don’t know they have it until they develop a much more serious illness called pelvic inflammatory disease, or PID. If you do experience symptoms, they may take the form of an unusual vaginal discharge, pain in the lower abdomen, pain or swelling of the labia, or pain or discomfort when you urinate. You can also get pus in the urine, which makes it look cloudy and usually makes it smell bad. (Unlike a urinary-tract infection, which quickly causes a very painful burning sensation during urination, a chlamydia infection progresses slowly.)

About 50 percent of men will have symptoms if they become infected. They may experience a whitish-yellow discharge from the penis, redness at its tip, plus a frequent urge to urinate or a burning sensation while doing so.

Can teenagers get chlamydia?

Yes. In fact, a survey of more than 14,300 people between 18 and 26 showed about one in every 25 were infected with chlamydia, according to the Journal of the American Medical Association.

Teenage girls are especially likely to contract it, in part because their cervixes aren’t yet fully developed, which makes them more vulnerable to infection. According to some studies, young women aged 15 to 19 account for as many as 46 percent of diagnosed chlamydia cases.

How will my doctor test for chlamydia?

If you’re a young woman, you may get a chlamydia test as part of your regular pelvic exam. The U.S. Centers for Disease Control and Prevention recommends that all women up to the age of 25 who are pregnant or at risk for the disease be tested annually. Some experts believe that sexually active teenagers should be tested twice a year by their family physicians, since they’re at high risk and don’t typically get an annual gynecological exam.

What might happen to me if I have this disease and don’t treat it?

For starters, you’ll probably pass the infection on to your sexual partner or partners.

In the middle stages of the disease, you’re likely to experience mild pelvic pain as the infection advances farther into your reproductive system. You might also spot between menstrual periods or after intercourse, and have a burning sensation when you urinate. More important, you can develop pelvic inflammatory disease if you’re among the 40 percent of women with untreated chlamydia. And PID can lead to infertility, premature birth or ectopic (tubal) pregnancy, or even death.

A man may develop epididymitis, an inflammation of the scrotal tubes that can cause sterility. Another possibility is a recurrent inflammation of the urethra, the tube through which urine passes.

In extreme cases, chlamydia can cause reactive arthritis or Reiter’s syndrome (arthritis with skin and eye lesions) in both men and women. Women may also get Fitz-Hugh-Curtis syndrome, or inflammation of the surface of the liver; its symptoms are abdominal pain and tenderness that are exacerbated by breathing, coughing, or movement. Although rare, it’s also possible to spread the bacteria to your eyes with a contaminated hand; this can cause conjunctivitis, an inflammation of the eye membranes.

Babies born to infected mothers may develop neonatal conjunctivitis and pneumonia, so if you’re pregnant you need to be tested for chlamydia and treated if necessary. Most hospitals now administer an antibiotic eye solution to all newborns just in case they’ve been exposed to chlamydia or another infection.

Can chlamydia be cured?

Definitely, but both you and your partner will have to be treated. Don’t be reluctant to seek help; there’s nothing wrong or shameful about having been sexually active. But both you and your partner do need to get treatment immediately, and to learn how to avoid any further infection with STDs as well.

To treat the infection, your doctor will prescribe antibiotic pills — either a one-dose drug called azithromycin, or another antibiotic that’s used for seven days. You won’t be able to have sex a week after you begin the treatment, and your doctor will schedule a follow-up exam in 8 to 12 weeks to make sure the infection has been killed. If you’re pregnant, you shouldn’t use azithromycin; you’ll probably be given erythromycin instead. Be sure to take all the antibiotics the doctor gives you — if you stop taking them once the symptoms are gone, the disease may not be cured.

If I’m in a monogamous relationship and I get chlamydia, does it mean my partner has cheated on me?

Not necessarily. Many people carry the chlamydia bacteria for months or years without knowing it.

Can I get chlamydia more than once?

Yes. Being treated for chlamydia doesn’t give you immunity to it. You can also be reinfected by a different partner or on a different occasion, even if you’ve already been treated for the disease.

What does chlamydia have to do with gonorrhea?

Studies show that people who have gonorrhea are frequently infected with chlamydia as well, so your doctor may treat you for both illnesses simultaneously if you have gonorrhea. The reverse isn’t true, though: People who are diagnosed as having chlamydia don’t generally have gonorrhea, too.

How can I keep from getting chlamydia?

Before you have sex with a new partner, both of you should first be tested for STDs; if you’re not in a monogamous relationship, make sure you or your partner use a condom every time you have sex. Don’t use condoms lubricated with spermicides – according to guidelines issued by the CDC, spermicides don’t protect against STDs. In fact, says the CDC, frequent use of spermicides containing nonoxynol-9 can cause genital lesions that may actually increase your risk of contracting STDs.

Many doctors also advise against douching, since that may have the effect of pushing a vaginal or cervical infection farther up into the uterus. If you’ve had sex with a new partner or partners, your regular physical or gynecological exam should include a chlamydia test; if you’re a teenager and sexually active, have the test twice a year. Your health insurance will usually cover screening for chlamydia and other sexually transmitted diseases. If you don’t have insurance, city public health clinics generally offer free testing.

References

Centers for Disease Control and Prevention. 2010 Guidelines

Centers for Disease Control and Prevention. Chlamydia. Sept. 10, 2010.

Miller William C. Prevalence of Chlamydial and Gonococcal Infections Among Young Adults in the United States JAMA. 2004;291:2229-2236

Burstein GR, et al. Incident chlamydia trachomatis infectiona among inner-city adolescent females. JAMA Aug 12 1998 280:521-526.

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