Chlamydia is the most common bacteria that causes sexually transmitted infections. Let’s learn the facts:
WHO?: Most infected people do not exhibit obvious signs or symptoms. The disease can affect men, women and newborns. Newborns are impacted when they are born to a mother who has an active infection. We will focus on discussing the impact to woman in this article.
WHERE?: In women the most common location for a chlamydial infection is the cervix. Some women can also have a urethral infection. The urethra is the location where urine leaves the body. The infection can also move upward through the pelvis and it can cause a condition called Pelvic Inflammatory Disease (PID). PID can cause infertility and chronic pain. This is a condition that will be discussed in a later posting. The bacteria can also cause rectal infections called Proctitis if a person engages in anal intercourse.
Infections can also impact the eyes (conjunctivitis) and the throat (pharyngitis).
After an infection some people can develop reactive arthritis.
WHAT?: 85% of women who have a chlamydia infection in their cervix do not have signs or symptoms. This is why your health care provider will likely perform an annual screening for chlamydia if you are a sexually active young woman, even if you have no signs/symptoms.
If symptoms are present they are usually mild and can include: change in vaginal discharge, spotting between periods and bleeding after sex. If there is an infection in the urethra as well there may be signs similar to a urinary tract infection (UTI).
WHEN?: If the infection occurs during pregnancy it can increase the risk for early rupture of membranes, preterm labor and low birth weight for the infant. There is also a risk of transmitting the infection to the newborn.
DIAGNOSIS: Testing can be performed by testing in the vagina (with a swab) or by checking the urine with a sample that can be submitted to a lab. If there are concerns for a rectal infection then a rectal swab will make the diagnosis. The same swabbing technique can be used to diagnosed conjunctival (eye) or pharyngeal (throat) infections.
TREATMENT: The goal of treatment is to prevent complications of untreated infection, like PID, infertility and chronic pain. If a person is diagnosed with chlamydia treatment is very simple and easy. For non-pregnant women, the recommendation is for Doxycycline 100 mg twice daily by mouth for 7 days. This needs to be obtained from a health care provider and requires a prescription.
The Centers for Disease Control (CDC) also agree with this treatment. It is very important that the entire treatment be completed. Another option is a single dose of Azithromycin. Sometimes this is easier since it only requires a one time dose, and it is the preferred option for pregnant women. However, there is evidence that suggests Doxycycline is a better treatment option, but not for pregnant women.
FOLLOW UP: It is best to avoid sexual intercourse until a woman and her partner have both been completely treated. It is recommended that those women who have been diagnosed and then treated for chlamydia be tested again after 3 months to ensure complete treatment and exclude reinfection.
If you are concerned about being exposed to chlamydia or have signs/symptoms reach out to your health care provider to schedule an appointment.
I am a Ob/Gyn practicing in Orange County, California. My area of focus since completing my training at USC has been Minimally Invasive Surgery and pelvic pain. My goals as a physician have included educating and being transparent with my patients about their diagnosis and treatment options. A team approach to pelvic pain and endometriosis has been proven to be most effective therefore, empowering my patients with accurate and evidence based information is essential to demystifying this often misunderstood condition.