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We’re all familiar with pop culture’s depictions of the unwelcome sensations that cause someone to seek out a sexually transmitted infection (STI) test: Itching, burning, the appearance of something that shouldn’t be there. Discharge is such an infamous symptom that gonorrhea gained the nickname “the drip.”
But some STIs have vague symptoms, and some often have no symptoms at all. Chlamydia is one such STI. It’s the most common notifiable STI in the United States, largely because it’s asymptomatic in the majority of cases.
But chlamydia can produce symptoms, and it’s important to be aware of what those are. Untreated chlamydia can lead to complications, particularly in women.
- “Chlamydia” comes from the Greek word chlamys, which means cloak, and “trachomatis” from the Greek for rough or harsh.
- In women, chlamydia usually infects the cervix first, causing cervicitis, or inflammation of the cervix. That can cause feelings of pain, irritation, or a vaginal discharge.
- Chlamydia bacteria can also irritate the urethra—in both men and women—leading to urethritis, which is often signified by pain while urinating.
- In men, untreated chlamydia can also cause epididymitis, a swelling in the tube in the back of the testicles, causing pain.
What is chlamydia?
Chlamydia is an STI caused by the Chlamydia trachomatis bacterium. It’s passed along during sexual contact with an infected person’s penis, vagina, mouth, or anus. Ejaculation doesn’t have to occur for it to be transmitted. Chlamydia can also be spread from mother to infant during childbirth.
According to the Centers for Disease Control and Prevention, chlamydia is the most common notifiable STI in the U.S. In 2017, more than 1.7 million cases were reported, but the agency estimates that 2.8 million people were actually infected with chlamydia. “A large number of cases are not reported because most people with chlamydia are asymptomatic and do not seek testing,” the CDC says (CDC, 2016).
According to the agency, only 10% of men and 5 to 30% of women who test positive for a chlamydia infection will develop symptoms. Here are the signs to watch for.
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What does chlamydia feel like?
In women, chlamydia usually infects the cervix first, causing cervicitis, or inflammation of the cervix. That can cause feelings of pain, irritation, or a vaginal discharge.
Chlamydia bacteria can also irritate the urethra, leading to urethritis, which is often signified by pain while urinating.
If left untreated, chlamydia can spread to the cervix, uterus, ovaries and fallopian tubes, causing abdominal pain or pelvic pain and pelvic inflammatory disease (PID).
In men, chlamydia bacteria can irritate the urethra and lead to urethritis, a swelling in the urethra, which causes pain while urinating and discharge. Untreated chlamydia can also cause epididymitis, a swelling in the tube in the back of the testicles, causing pain.
Chlamydia can infect the eyes, causing chlamydial conjunctivitis (a type of pinkeye). Symptoms include redness, infection, and discharge.
Chlamydia can also infect the rectum, either through anal sex or the spread of bacteria from the cervix or vagina. This might produce pain, discharge or bleeding, or no symptoms at all.
Chlamydia trachomatis is also the bacteria responsible for a condition called lymphogranuloma venereum (LGV). LGV is caused by three strains of Chlamydia trachomatis which gain entrance to the body via breaks in the skin, though it can also cross through mucous membranes. From here, the organism travels to the lymph nodes, resulting in tender swollen areas or abscesses in the groin. It can also cause inflammation in the rectum which is accompanied by gastrointestinal symptoms.
Before 2003, the condition was considered rare in developed nations, but an outbreak (Kivi, 2008) in the Netherlands among gay men has resulted in LGV becoming more common in both the United States and Europe (De Barbeyrac, 2018).
Although chlamydia can be found in the throat of people who have oral sex with an infected partner, it generally doesn’t produce symptoms, according to the CDC.
Complications of chlamydia
Untreated chlamydia can cause several complications, most seriously in women.
It’s essential to seek treatment for chlamydia promptly because pelvic inflammatory disease (PID) can cause damage to the female reproductive system. PID can lead to scarring or blockages in the fallopian tubes, raising the risk of infertility or ectopic pregnancy. In the latter condition, a fertilized egg implants in the fallopian tube instead of the uterus, which can cause the tube to rupture, potentially leading to shock and severe blood loss. This can be fatal.
Chlamydia can also be spread from mother to infant during childbirth, and it can cause premature delivery or pneumonia in the baby (Rours, 2011).
Some women with PID can develop Fitz-Hugh-Curtis Syndrome, an inflammation of the liver and surrounding tissues, which is signified by pain in the right upper quadrant.
In rare cases, chlamydia in men can cause prostatitis (inflammation of the prostate), scarring of the urethra or infertility.
Treatment of chlamydia
Most cases of chlamydia can be cured with antibiotics. Azithromycin or doxycycline is typically used. Azithromycin can be given as a single large dose and is usually combined with ceftriaxone, which is intended to treat gonorrhea (since these STIs often occur together). If your healthcare provider prescribes you doxycycline, the typical course is seven days long. To treat LGV, the typical course is 21 days long.
If you’re diagnosed with chlamydia, don’t have sex for seven days after beginning antibiotics and inform any sexual partners that you had within 60 days of the onset of symptoms.
History of chlamydia
The bacteria Chlamydia trachomatis was discovered in 1907 by a German scientist. “Chlamydia” comes from the Greek word chlamys, which means cloak, and “trachomatis” from the Greek for rough or harsh.
Rates of chlamydia, like other STIs, are rising in the United States. Researchers theorize a decline in condom use and cuts in funding for STI education programs may be responsible. In 2017, the rate was 529 cases for every 100,000 people, an increase of 7% from the year before.
Although chlamydia is most common among young people — the CDC estimates that 1 in 20 sexually active young women between the ages of 14 and 24 have chlamydia — anyone who is sexually active can contract it. That’s just one reason why regular STI screening is a good idea. Talk to your health care provider about what’s right for you.