Here’s another post in our on-going STD series. Are you looking for the plain truth? Then read this. It’s all fact.

What is chlamydia?

Chlamydia is a common sexually transmitted disease (STD) caused by bacteria (Chlamydia trachomatis).  It can damage a woman’s reproductive organs, even causing her to be unable to have a child.  Because symptoms of chlamydia are mild or absent, it can cause permanent damage that cannot be undone before a person even knows about it.

How do people get chlamydia?

Chlamydia can be transmitted during vaginal, anal or oral sex.  Chlamydia can also be passed from an infected mother to her newborn during vaginal (common) childbirth.

How common is chlamydia?

In the United States, Chlamydia is reported more often than any sexually transmitted infection caused by bacteria.  More than 650,000 cases were reported in 1999 and three of every four of these occurred in persons under age 25.  This number is probably low because so many people with the disease do not know they have it.  About 3 million Americans are infected with chlamydia each year.  Chlamydia is very common in young women.  By the age 30, 50% of sexually active women may have had chlamydia at some time during their lives. (***Utah is currently one of the top 4 states with highest Chlamydia rates.)

What are the symptoms?

Chlamydia is known as a “silent” disease.  Three quarters of infected women and half of infected men have no symptoms.  The infection is frequently not diagnosed or treated until complications develop.

In women, the bacteria initially attack the opening to the uterus (cervix) and the urine canal (urethra).  The few women with symptoms might have an abnormal vaginal discharge or a burning sensation when urinating.  When the infection spreads from the cervix to the fallopian tubes (the tubes that carry the egg to the uterus), some women still have no symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercouse and bleeding between menstrual periods.  Whenever the infection spreads past the cervix into the upper reproductive system, permanent damage can occur.

Men with symptoms might have a discharge from the penis and a burning sensation when urinating.  Men might also have burning and itching around the opening of the penis or pain and swelling in the testicles or both.

How soon do symptoms appear?

If symptoms do occur, they usually appear within 1 to 3 weeks of exposure to the disease.

Who is at risk for chlamydia?

Sexually active men and women can be exposed to chlamydia bacteria during sexual contact with an infected person.  The more sex partners a person has, the greater the risk of chlamydia infection.  Babies are at risk of receiving this infection from their infected mother.  Sexually active teenagers and young women are especially at risk from the chlamydia bacteria because of the characteristics of the cells that form the lining of the cervical canal.

What is the treatment?

Chlamydia can be treated and cured with antibiotics.  A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments.

What if chlamydia isn’t treated?

Most women do not have symptoms and do not know they need treatment.  Chlamydia infection can grow into serious reproductive and other health problems.  Like the disease itself, the damage that chlamydia causes is often “silent”.  Untreated chlamydia in men typically causes urethral infection.  Infection sometimes spreads to the tube that carries sperm from the testis and can cause pain, fever and infertility.

In women, the chlamydia bacteria often infects the cells of the cervix.  If not treated, the infection can spread into the uterus or fallopian tubes (egg canals) and cause an infection called pelvic inflammatory disease (PID).  This happens in up to 40% of women with untreated chlamydia .  PID can cause permanent damage to the fallopian tubes, uterus and tissues surrounding the ovaries.  This damage can lead to chronic pelvic pain, infertility and potentially fatal ectopic pregnancy (pregnancy outside the uterus).

In pregnant women, there is some evidence that infections from chlamydia can lead to premature delivery.  Babies who are born when their mothers are infected can get infections from chlamydia in their eyes and respiratory tracts.  Chlamydia is a leading cause of early infant pneumonia and conjuctivitis (pinkeye) in newborns.

Compared to women who do not have chlamydia, women infected with chlamydia may also have higher risk of acquiring HIV infection from an infected partner.  Chlamydia can also cause proctitis (an infection of the lining of the rectum) in persons having receptive anal intercouse.  Chlamydia bacteria can be found in the throats of women and men having oral sex with an infected male partner.

How can chlamydia be prevented?

The surest way to avoid infection with any sexually transmitted disease, including chlamydia, is to practice sexual abstinence (abstain from any sexual contact) while single.  If you marry, select a partner who is not infected with an STD and remain sexually faithful during marriage.

Condoms do not provide complete protection from STDs.  Infection can occur in both males and females whether or not a condom is used. (***Because of skin to skin contact during sexual activity, condoms won’t provide full protection, since condoms don’t cover all of the area invloved.)

A recent review by the Centers for Disease Control (CDC) determined that there is no clinical proof that condoms are effective in reducing the risk of this STD.1

IF you suspect an infection due to past sexual activity, get a screening test.  It has been shown that screening and treatment of women with chlamydia infection of the cervix reduces the likelihood of PID.  All pregnant women should have a screening test for chlamydia.

If you have any genital signs or symptoms such as discharge or burning during urination or an unusual sore or rash you should consult a health care provider immediately.

Methods of birth control, like the oral contraceptive pill or the contraceptive shot or implant do not give women protection from STDs.

Sources and Resources:

Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention, Divisions of HIV/AIDS Prevention, Workshop Summary:  Scientific Evidence on Condom Effectiveness for  Sexually Transmitted Disease (STD) Prevention June 12-13, 2000, found at: http://www.niaid.nih.gov/dmid/stds/condomreport.pdf, accessed 1-5-04.  (A review of 138 scientific studies concerning condom effectiveness published  July 20, 2001.)

Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention Division of Sexually Transmitted Disease, Chlamydia Disease Information, May 2001.  Technical update November 3, 2003.  Http://www.cdc.gov/nchstp/dstd/Fact_Sheets/FactsChlamydiaInfo.htm, accessed 1/5/04, using the following sources:

American Social Health Association.  Sexually transmitted diseases in America:  How many cases and at what cost?  Research Triangle Park, NC, 1998.

Centers for Disease Control and Prevention.  1998 Guidelines for Treatment of Sexually Transmitted Diseases.  MMWR 1998; 47(RR-1).

Division of STD Prevention.  Sexually Transmitted Disease Surveillance, 1999.  Department of Health and Human Services, Atlanta:  Centers for Disease Control and Prevention (CDC), September 2000.

Division of STD Prevention, Sexually Transmitted Disease Surveillance, 1998.  Department of Health and Human Services, Atlanta:  Centers for Disease Control and Prevention (CDC), September 1999.

Stamm, W.E.  In: K. Holmes, P. Mardh, P. Sparling et al (eds).  Sexually Transmitted Diseases, 3rd edition.  New York:  McGraw-Hill, 1999, 407-422.