Everything you need to know about chlamydia

What is chlamydia?

Chlamydia trachomatis is a bacterial infection transmitted through sexual contact (semen or vaginal fluid). Infection can occur via vaginal, anal, and oral sex and even when a man does not ejaculate. It is treated with antibiotic, usually azithromycin or doxycycline.

Who is at risk of infection?

Anyone who has had unprotected sex (vaginal, oral, or anal). It can also be transmitted by shared sex toys. Women can also pass the infection to their babies during childbirth.

Always use a condom – when used correctly the risk of transmission of chlamydia is much reduced.

Should I get tested for chlamydia?

It is safest to get tested before starting a sexual relationship, so an infection can be treated before any sexual contact. NHS England recommend under 25s that are sexually active should get tested on an annual basis, and also when they have a new sexual partner.

Where can I get tested?

Sexual health clinics, a genitourinary medicine (GUM) clinic, or doctor’s surgeries provide free and confidential testing. In England there is a national chlamydia screening program for people under 25 years: urine swab tests are available in many pharmacies, contraception clinics, and colleges. Home testing kits may also be purchased in some pharmacies and online.
50% of men and 75% of women with a chlamydia infection will have no symptoms
What are the symptoms?

50% of men and 75% of women with a chlamydia infection will have no symptoms, so taking a urine test at your doctors surgery, sexual health clinic, or a local pharmacy is the only way to know for sure if you have it.

If symptoms do appear they are usually genitourinary and usually develop within 1-3 weeks (but can take many months). Men may experience pain or swelling of the testicles, a burning sensation when passing urine, and discharge from the penis. Typical symptoms for women include vaginal discharge, bleeding after sex (vaginal) or between periods, a burning sensation when passing urine, and pain in the pelvis or lower abdomen.

What about symptoms elsewhere?

Chlamydia is spread by contact with infected semen or vaginal fluid. The anus, throat, or eyes can be affected:

  • Anal symptoms include soreness, with discharge that can contain blood.
  • The throat can have symptoms similar to a viral sore throat.
  • Eyes may become red, sore, and gritty with discharge.

How long have I had it?

Unless you have a very good recollection of your sexual history it is usually not possible to know how long you have been infected. A test cannot provide this information either.

Am I at risk of other infections?

If you caught chlamydia through unprotected sexual contact (anal, vaginal, oral) you are also at risk of catching other sexually transmitted infections such as genital warts, genital herpes, gonorrhoea, HIV, pubic lice, and syphilis. Your doctors surgery or sexual health clinic will also offer testing for these infections as well.

Should I tell my partner(s)?

It is important to let your current sexual partner(s) know if you have chlamydia, as they are at risk of having (and further spreading) the infection too. All sexual partners in the previous 6 months should also be informed.

If you feel embarrassed telling partners please remember it is important (and also respectful) to let them know as soon as possible, so they have an opportunity to get tested and treated. You may be surprised how supportive partners are, and appreciative being confided in.

Both current partners should be treated at the same time, and abstain from sex (that means no genital, oral, or anal sex – even with a condom) for one week from the start of treatment, by which time the infection will have gone. Otherwise partner’s can re-infect each other.

My symptoms have gone, without any treatment?

Do not assume that the infection has cleared up as symptoms can disappear despite an infection persisting. You could still be infected and pass it on, so get tested and get treated if required.

What happens if I don’t get treated?

Chlamydia is unlikely to go away without treatment with antibiotics, and can be passed onto sexual partners and can cause serious harm.

Women can get cervicitis (inflammation of the cervix with bleeding, discharge and painful sex) or pelvic inflammatory disease. This can result in permanent damage to the fallopian tubes, which causes infertility or ectopic pregnancy (which can be life threatening). Chlamydia also can cause a reactive arthritis.

Men can suffer with urethritis (inflammation on the urethra, symptoms include discharge, pain passing urine, and sore skin at the penis tip), which can spread to the contents of the scrotal sac – epididymus and testicles. This causes pain, and in severe cases infertility. Men can also get a reactive arthritis.

How can I get treatment?

There are numerous options for seeking treatment in the UK. Visit either your doctors surgery, a GUM/sexual health clinic, Brook clinic, your local pharmacy, or buy online from a regulated online doctor and pharmacy.

Treatment is with antibiotic, usually:

  • Azithromycin 1000mg single dose: Take 4 x 250mg tablets at the same time, on an empty stomach (1+ hour before or 2+ hours after a meal).
  • Doxycycline 100mg twice daily for 1 week: Take 100mg capsule every 12 hours for one week. Swallow whole with water and whilst upright (sitting up or standing). Can be taken with a meal.

How long for symptoms to clear?

Once you have started antibiotic treatment symptoms will usually settle quickly. Pain when passing urine and discharge should go within 1 week, pelvic or testicular pain can take 2 weeks, and an irregular period should improve by the next menstrual cycle.

If symptoms do not clear up you should seek tests for other infections at your local doctor’s surgery or sexual health/GUM clinic.

Can chlamydia cause cervical cancer?

No it cannot. Some strains of human papilloma virus (HPV) increase the risk of developing cervical cancer. Girls are routinely offered free NHS vaccination against HPV at age 12-13. HPV vaccination is also available privately from some clinics and pharmacies.

I’m pregnant – can chlamydia affect my baby?

Infection can spread to the baby from the birth canal during childbirth. It can cause eye infection or pneumonia in newborns. Chlamydia infection may be associated with premature births and low birth weight. Testing and treatment of chlamydia during pregnancy can prevent these complications. Doxycycline cannot be taken during pregnancy, but azithromycin is safe and effective.

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