Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman’s reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur “silently” before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.
Under-reporting is substantial because most people with chlamydia are not aware of their infection and therefore do not seek testing or treatment. Also, testing is not often done if patients are treated for their symptoms. An estimated 3 million Americans a year are infected with chlamydia. Women are frequently re-infected if their sex partners are not treated.
Any sexually active person can be infected with chlamydia. The greater the number of sex partners, the greater the risk of infection. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured, they are at particularly high risk for infection if sexually active. Since Chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for chlamydial infection.
In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes (tubes that carry eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection on the cervix can spread to the rectum.
Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.
Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected male partner.
In women, untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in up to 40 percent of women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.
To help prevent the serious consequences of chlamydia, an annual screening test for chlamydia is recommended for all sexually active women age 25 years and younger. An annual screening test also is recommended for older women with risk factors for chlamydia (a new sex partner or multiple sex partners).
Complications among men are rare. Infection sometimes spreads to the epididymis (a tube that carries sperm from the testis), causing pain, fever, and, rarely, sterility.
Rarely, genital chlamydial infection can cause arthritis that can be accompanied by skin lesions and inflammation of the eye and urethra (Reiter’s syndrome).
All sex partners should be evaluated, tested, and treated if necessary. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible.
Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple infections increases a woman’s risk of serious reproductive health complications, including infertility. Women, especially adolescents, should consider retesting for chlamydia three to four months after treatment is completed. This is especially true if a woman does not know if her sex partner received treatment.
Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.
Chlamydia screening is recommended annually for all sexually active women 25 years of age and younger. All pregnant women should have a screening test for chlamydia. In addition, women older than 25 years whose sexual practices put them at risk for chlamydial infection should be tested at least once a year. It has been shown that screening and treatment of women with chlamydial infection of the cervix reduces the likelihood of PID.
Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a signal to stop having sex and to consult a health care provider immediately. If a person has been treated for chlamydia (or any other STD), he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from chlamydia and will also reduce the person’s risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for chlaymdia.
If you think you may have a sexually transmitted disease, you should see a physician immediately to be properly diagnosed and treated. You should not try to diagnose or treat symptoms on your own.
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