What Is Chlamydia?
Chlamydia is a sexually transmitted infection (STI) caused by the bacterium chlamydia trachomatis. In the UK, the number of new diagnoses has been steadily increasing each year since the mid-1990s, and it has now become the most commonly diagnosed STI.
Chlamydia is called the ‘silent’ disease because most people who get it do not experience any noticeable symptoms. Around 50% of men and 70-80% of women who get the chlamydia infection will have no symptoms and many cases of chlamydia remain undiagnosed.
How common is it?
Between 2007 and 2008, the number of confirmed cases of chlamydia rose from 121,791 to 123,018. Young people under 25 are most likely to be infected, 65% (80,258) of all new chlamydia diagnoses made in 2008 were in people between the ages of 16 and 24.
Symptoms of Chlamydia
Chlamydia often goes unnoticed due to the lack of noticeable symptoms. Because of this, many cases of chlamydia remain undiagnosed.
Women
In women, genital chlamydia does not always cause symptoms. Signs and symptoms can appear 1-3 weeks after coming in contact with chlamydia, many months later or not until the infection has spread to other parts of your body.
Some women may notice:
* Cystitis (pain when passing urine),
* a change in their vaginal discharge,
* lower abdominal pain,
* pain and/or bleeding during sexual intercourse,
* bleeding after sex, or
* bleeding between periods or heavier periods.
If left untreated the chlamydial infection can spread to the womb, and cause Pelvic Inflammatory Disease (PID). PID is a major cause of infertility, ectopic pregnancy and miscarriage.
Men
Symptoms of genital chlamydia are more common in men than in women. Signs and symptoms can appear 1-3 weeks after coming in contact with chlamydia, many months later or not until the infection has spread to other parts of your body.
Some men may notice:
* a white, cloudy or watery discharge from the tip of the penis,
* pain when passing urine, or
* pain in the tesiticles.
Some men experience mild symptoms that disappear after two or three days. However, after the discomfort disappears, you may still have the chlamydia infection. This means that you can pass it on to a sexual partner and you are at risk of complications such as inflamed and swollen testicles, reactive arthritis and infertility.
Men and women
Very rarely the chlamydia infection may affect areas other than the genitals in both men and women, such as the rectum, eyes or throat.
If the infection is in the rectum it can cause some discomfort and discharge. In the eyes it can cause pain, swelling, irritation and discharge (conjunctivitis). Infection in the throat is very rare and does not usually cause any symptoms.
Causes of chlamydia
As chlamydia is a sexually transmitted infection (STI), it is transmitted (passed on) from one person to another during intimate sexual contact. You can catch chlamydia through having:
* unprotected vaginal sex,
* unprotected anal sex,
* unprotected oral sex,
* genital contact with an infected partner, or
* sharing sex toys if they are not washed or covered with a condom each time they are used.
If infected semen or vaginal fluid comes into contact with the eye, it can cause conjunctivitis.
It is not clear whether chlamydia infection can be spread by transferring infected semen or vaginal fluid on the fingers or by rubbing female genitals (vulvas) together.
As it is common for someone with the chlamydia infection not to have symptoms, it is possible for him or her to infect a partner without knowing.
Chlamydia can be passed from a mother to her baby during childbirth. Although no obvious symptoms are immediately apparent, the infection will often develop after birth, and can result in complications such as inflammation and discharge in the baby’s eyes (conjunctivitis) and pneumonia.
Diagnosis chlamydia
The only way to be certain that you have chlamydia is to be tested. If you suspect you could have chlamydia, it is important not to put off having a test done.
Early diagnosis and treatment of chlamydia will reduce the risk of any complications developing. Complications that arise from long-term chlamydial infection are much more difficult to treat.
The accuracy of chlamydia testing depends on what kind of test is used. Recommended tests are over 90% accurate in picking up the infection, shop bought tests may be less reliable.
There are different ways to test for chlamydia
:
Women
Women can be tested for chlamydia by taking a swab from the cervix (neck of the womb) or using a urine sample.
In recent years tests have been developed that allow women to carry them out at home, by using a urine sample, or by taking a swab themselves from the lower vagina. The sample is put into a container and sent to a laboratory to be tested.
Routine cervical screening tests do not detect chlamydia. Ask your doctor or nurse if you also wish to be tested for chlamydia.
Men
In the past, the chlamydia test for men involved putting a swab into the opening of the urethra at the tip of the penis to collect a sample of cells. A urine test is now commonly used. This method is slightly less reliable than using a swab, but it is a much easier and less uncomfortable.
Testing for non-genital chlamydia
If you have had anal or oral sex, a swab of calls may be collected from your rectum or throat, but this is not done routinely.
If you have symptoms of conjunctivitis, such as discharge from the eyes, a swab may be taken to collect cells from your eye.
When to get tested
Statistics from the National Chlamydia Screening Programme (NCSP) in England show that you are more at risk of becoming infected with chlamydia if you are under 25, have a new sexual partner, or have had more than one sexual partner in the past year and have not used condoms.
It is recommended that you consider getting tested for chlamydia if:
* you or your partner think you have symptoms,
* you have had unprotected sex with a new partner,
* you or your partner have unprotected sex with other people,
* you have an STI,
* a sexual partner tells you that they have an STI,
* during a vaginal examination your nurse or doctor tells you that the cells of your cervix are inflamed or there is discharge, or
* you are pregnant or planning a pregnancy.
Where to get tested
There are a number of different places you can go to for a chlamydia test, you can chose the place most comfortable and convenient for you:
* a genitourinary medicine (GUM) or sexual health clinic,
* your GP surgery,
* a contraceptive and young people’s clinic, or
* pharmacists where you can buy a chlamydia test to do at home – some tests may be more reliable than others so it is best to ask your pharmacist for advice.
The National Chlamydia Screening Programme (NCSP) offers free tests to men and women under 25 who have been sexually active. The programme runs across the UK and can help you access local chlamydia screening services. The screening takes place in a variety of community settings, including GP surgeries, military bases, contraceptive clinics, sexual health and GUM clinics, pharmacies, gynaecology departments and youth centres. To find out more, visit the NCSP website or call the sexual health helpline on 0800 567 123.
You can find details of your nearest sexual health or GUM clinic in the phone book, or by using the local health service search. You can attend these clinics at any age, even if you are less than 16 years of age (the age of consent for sex), and all results are treated confidentially.
Chlamydia treatment
The common treatment for chlamydia is a course of antibiotics. If taken correctly it is more than 95% effective. The course of antibiotics can be either a single dose, or a longer course of up to two weeks.
If there is a high chance that you have been infected with chlamydia, treatment may be started before you receive your test results. You will always be given treatment if your partner is found to have chlamydia.
The two most commonly prescribed antibiotics to treat chlamydia are:
* Azithromycin (single dose)
* Doxycycline (usually two capsules a day for a week)
Other less commonly prescribed antibiotics include Ofloxacin, Amoxicillin and Erythromycin.
It is important that you finish all the capsules prescribed to you. If you do not, the treatment may not be effective at getting rid of the infection.
You can discuss with your GP which antibiotic is the most suitable for you. If you are pregnant, for example, some antibiotics may not be suitable, but alternatives are available. Azithromycin, Amoxicillin and Erythromycin are all suitable for pregnant women..
Antibiotics used to treat chlamydia may interact with the combined contraceptive pill and the contraceptive patch. If you use these methods of contraception, you can discuss with your GP or nurse which additional contraception is suitable for this time.
Side effects
The side effects of antibiotics are usually mild, the most common side effects include:
* stomach pain,
* diarrhoea, and
* feeling sick.
Occasionally, Doxycycline can cause a skin rash if you are exposed to too much sunlight (photosensitivity).
Sexual partners
Chlamydia is easily passed on through intimate sexual contact. If you are diagnosed with the infection, anyone you have recently had sex with in the last six months may also have it. It is important that your current partner and any other recent sexual partners are tested and treated.
Your local genitourinary medicine (GUM) or sexual health clinic may be able to help by notifying any of your previous partners on your behalf. A contact slip can be sent to them explaining that they may have been exposed to a sexually transmitted infection (STI) and suggesting that they go for a check up. The slip sometimes notes what the infection is but will not have your name on it, so your confidentiality is protected.
If you or your current partner is diagnosed with chlamydia, you should not have sex until you have both finished your course of treatment.
Claymydia prevention
Chlamydia can be successfully prevented by:
* using condoms (male or female) every time you have vaginal or anal sex,
* using a condom to cover the penis or latex or plastic square (dam) to cover the female genitals if you have oral sex, and
* not sharing sex toys. If you do share them wash them or cover them with a new condom before anyone else uses them.
These measures can also protect you from other sexually transmitted infections (STIs), such as genital herpes and gonorrhoea.
If you are worried you may be at risk of having an STI or have any of the symptoms mentioned in the symptoms section, you should visit your local sexual health or GUM clinic to have them checked out.
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