What is chlamydia?

Chlamydia is a sexually transmitted infection that affects men and women. It is particularly prevalent in sexually active teenagers and young adults. There were over 131 million new cases globally in 2018 and over 220,000 in England. Health authorities are now speaking in terms of a chlamydia epidemic. One of the reasons why chlamydia has spread so rapidly is that the disease does not always cause obvious symptoms. Many sufferers are unaware that they are infected and unknowingly infect new sexual partners. Chlamydia may be successfully treated with antibiotics in up to 95% of cases.

Symptoms of chlamydia

• Pain when urinating
• Unusual discharge from the vagina, penis or anus
• Women may experience bleeding after sex and bleeding between periods
• Men may experience painful or swollen testicles

Chlamydia is spread through unprotected sexual contact between partners. You do not have to have full sex to be infected. If there is any contact between your genitals and your partner’s genitals, or any infected seminal or vaginal fluid gets in your eye (e.g. you inadvertently rub your eye after touching your partner’s genitals) you may be at risk of infection.

The long-term consequences of untreated chlamydia may be serious for both sexes. They include a risk of pelvic inflammatory disease (PID), epididymo-orchitis (inflammation of the testicles), infertility and occasionally reactive arthritis. Pregnant women can also pass the infection on to their babies.

Causes of chlamydia

Chlamydia is a sexually transmitted infection caused by the bacteria Chlamydia trachomatis. It is spread through unprotected sexual contact with an infected partner. Even if you have protected sex using a condom, you may still be at risk of catching chlamydia. The bacteria can spread if infected bodily fluids enter your eye or other bodily orifices. This could be caused by something as simple as rubbing your eye after sex if you have traces of vaginal or seminal fluid on your fingers.

How do I get chlamydia?

The main cause of chlamydia infection is unprotected vaginal, anal or oral sex. Men and women are both at risk, regardless of their partner’s gender. The infection can also be spread by sharing sex toys. Any sex toy should be thoroughly washed or covered with a new condom before being used by a partner. If your genitals touch your partner’s genitals e.g. during foreplay or non-penetrative sex, you may be at risk of infection. 

• Unlike some sexually transmitted infections, there are no visible symptoms of chlamydia which means that you cannot see if someone is infected. 
• It is possible to be infected with chlamydia and not have any symptoms at all. The infection is often unknowingly spread by people who do not realise that they are infected.
• Couples may wrongly assume that they are having safe sex because there is no penetration or because they are using a condom. This will not automatically protect you against chlamydia.

Symptoms of Chlamydia 

It is possible to be infected with chlamydia (and able to spread the infection) without experiencing any noticeable symptoms. If you do experience any of the following symptoms they may be caused by chlamydia infection and you should seek medical advice before having any sexual activity. 

Chlamydia symptoms in women

• Pain when urinating
• Unusual discharge from the vagina or anus
• Stomach pains, vaginal bleeding after sex and between periods

Possible complications

• Pelvic inflammatory disease (PID)
• Pregnancy complications and damage to your unborn child
• Reactive arthritis (SARA)
• Risk of infertility

Chlamydia symptoms in men

• Pain when urinating
• Unusual discharge from the penis or anus
• Painful or swollen testicles

Possible complications

• Epididymo-orchitis
• Reactive arthritis (SARA)
• Risk of infertility

Oral chlamydia symptoms in men and women

A chlamydia infection can also occur in your throat, usually as a result of unprotected oral sex. If symptoms occur, they may include:

• Painless sores in the mouth
• Lesions similar to cold sores around the mouth
• Tonsillitis
• Redness with white spots resembling strep throat
• Scratchy, dry throat

Any of the above symptoms may also be unrelated to chlamydia, and could be signs of another sexually transmitted infection or medical issue. It is important to get checked. 

Important
If you are sexually active (outside a monogamous relationship with a trusted partner) it is important to get tested for chlamydia regularly. A simple swab or urine test is usually sufficient for diagnosis and self-testing kits are also available.

Diagnosis of chlamydia

An initial diagnosis of chlamydia may be made based on the symptoms, but these are not always be present. Chlamydia can be fully diagnosed with a urine test or a swab. Both procedures are quick and accurate. Many people who are infected have no outward symptoms at all. If you are sexually active, you should take an annual test for chlamydia. If you have recently had unprotected sex, you should also consider taking a test. The incubation period for a chlamydia infection can range from a few days to several months, although the average time from exposure to the bacteria to the development of symptoms is 1 -3 weeks. 

Chlamydia symptoms checklist

If you are sexually active (especially if you have had unprotected sex) and you experience any of the following symptoms, you may have chlamydia.

Treatments for chlamydia

Chlamydia is a sexually transmitted infection caused by the chlamydia trachomatis bacteria. It is usually treated by a short course of antibiotics. In the UK available treatments include Doxycycline and Azithromycin. 

Used correctly, antibiotics will usually successfully cure 95% of cases at the first treatment.

An online doctor will give you precise instructions about how to take any course of antibiotics. These will usually include not having sex for at least 7 days after you (and if relevant) your partner begin treatment. You may also be advised to take a second test after a period of three months. If you contracted chlamydia through unprotected sex, you may also be advised to have a full range of STD tests, including an HIV test. 

Prevention of chlamydia

Chlamydia is a highly contagious sexually transmitted infection. It can be passed on accidentally even when using condoms. The only guaranteed ways to prevent chlamydia are to abstain from sex, or to only to have sex with a trusted partner in a monogamous relationship. 

If you are sexually active with a variety or partners, or with a partner who you cannot trust 100%, there are certain steps that you can take to reduce the risk of chlamydia (and other sexually transmitted infections).

• Always use a condom for penetrative sex.
• Always use a condom (on the penis) or a dental dam over the vaginal area) when performing oral sex.
• Do not allow your genitals to touch your partner’s genitals, if you are not having penetrative sex.
• Wash your hands immediately after sex, and do not put your fingers in your mouth or rub your eyes until you have done so. 
• If you are sharing sex toys they must be washed thoroughly or covered with a new condom before use.