What You Should Know About Chlamydia and Its Treatment
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What You Should Know About Chlamydia and Its Treatment

Anna Lange (not her real name) had no symptoms when she went to a Wake County, NC, sexually transmitted diseases (STD) clinic earlier this year to pick up her birth control pills. But a routine test revealed that the 20-year-old had chlamydia.

"She came in and had no complaints," says Peter Leone, MD, the clinic's medical director, "and then 'boom,' she was diagnosed with a sexually transmitted disease."

What Is Chlamydial Infection?

Chlamydial ("kla-MID-ee-uhl") infection is a curable sexually transmitted disease (STD), which is caused by a bacterium called Chlamydia trachomatis.You can get genital chlamydial infection during oral, vaginal, or anal sexual contact with an infected partner.

It can cause serious problems in women as well as in newborn babies of infected mothers. Men may occasionally develop painful complications, but they rarely experience serious disease. Chlamydial infection is one of the most widespread bacterial STDs in the United States. The US Centers for Disease Control and Prevention (CDC) estimates that more than 4 million people are infected each year.

The infection may move inside a woman’s body if it is not treated. There, it can cause pelvic inflammatory disease (PID). C. trachomatis can cause inflamed rectum and inflammation of the lining of the eye ("pink eye"). The bacteria also can infect the throat from oral sexual contact with an infected partner. Men may develop the painful condition called epididymitis.

Symptoms of Chlamydia

Because chlamydial infection does not make most people sick, you can have it and not know it.Those who do have symptoms may have an abnormal discharge (mucus or pus) from the vagina or penis or pain while urinating. These early symptoms may be very mild. Symptoms usually appear within 1-3 weeks after being infected. Because the symptoms may be mild or not exist at all, you might not seek care and get treated.

Complications of Chlamydia

The most serious complication of chlamydia is impaired fertility. Women who develop pelvic inflammatory disease have a significantly reduced likelihood of becoming pregnant because of scarring of their fallopian tubes. A second (or especially a third) episode of pelvic inflammatory disease may make childbearing very unlikely or even impossible.

Only recently has it been recognized that chlamydia may be associated with infertility in men as well. Recent data suggests that the body produces antibodies in response to chlamydia, and these antibodies may interfere with sperm survival. The association between chlamydia and male infertility remains incompletely understood and is still somewhat controversial.

Chlamydia Infection Can Affect a Newborn Baby

A baby who is exposed to C. trachomatis in the birth canal during delivery may develop an eye infection or pneumonia. Symptoms of conjunctivitis or "pink eye," which include discharge and swollen eyelids, usually develop within the first 10 days of life. Symptoms of pneumonia, including a cough that gets steadily worse and congestion, most often develop within 3-6 weeks of birth. Doctors can treat both conditions successfully with antibiotics. Because of these risks to the newborn, many doctors recommend that all pregnant women get tested for chlamydial infection. Infections may also lead to premature delivery or miscarriage during pregnancy.

No one screening method is best, Leone says. "It's a tradeoff. We're constantly balancing what is the cheapest test with what is the most sensitive, what is easiest to get from the patient versus what will pick up the most infections."

Diagnosis and Treatment of Chlamydia

Diagnosis

Chlamydial infection is easily confused with gonorrhea because the symptoms of both diseases are similar and the diseases can occur together, though rarely. The most reliable ways to find out whether the infection is chlamydial are through laboratory tests. Usually, a doctor or other healthcare worker will send a sample of pus from the vagina or penis to a laboratory that will look for the bacteria.A urine test is also available and does not require a pelvic exam or swabbing of the penis. Results from the urine test are available within 24 hours.

Treatment

If you are infected with C. trachomatis, your doctor or other healthcare worker will probably give you a prescription for an antibiotic such as azithromycin (taken for one day only) or doxycycline (taken for seven days) to treat people with chlamydial infection. Or, you might get a prescription for another antibiotic such as erythromycin or ofloxacin. Doctors may treat pregnant women with azithromycin or erythromycin, or sometimes, with amoxicillin. Penicillin, which doctors often use to treat some other STDs, won't cure chlamydial infections.

If You Have Chlamydial Infection

If you have chlamydial infection:

  • Take all of the prescribed medicine, even after symptoms disappear.
  • If the symptoms do not disappear within 1-2 weeks after finishing the medicine, go to your doctor or clinic again.
  • It is very important to tell your sex partners that you have chlamydial infection so that they can be tested and treated.

Preventing Chlamydial Infection

You can reduce your chances of getting chlamydia or giving it to your partner by using male latex condoms correctly every time you have sexual intercourse (oral, anal, or vaginal). If you are infected but have no symptoms, you may pass the bacteria to your sex partners without knowing it. Therefore, many doctors recommend that anyone who has more than one sex partner, especially women under 25 years of age, be tested for chlamydial infection regularly, even if they don't have symptoms.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

The National Center for HIV, STD, and TB Prevention
Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/nchstp/od/nchstp.html

National Institute of Allergy and Infectious Diseases
www.niaid.nih.gov

CANADIAN RESOURCES:

Sex Information and Education Council of Canada
http://www.sieccan.org/

Sexualityandu.ca
http://www.sexualityandu.ca/home_e.aspx

References:

Chlamydial infection. National Institutes of Allergy and Infectious Diseases website. Available at: http://www.niaid.nih.gov/factsheets/stdclam.htm. Accessed on December 10, 2001.

Eley A, et al. Can chlamydia trachomatis directly damage your sperm? Lancet Infect Dis. 2005:53-7.

National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/chlamydiainfections.html. Accessed December 10, 2002.



Last reviewed May 2008 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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