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Chlamydia is one of the most common sexually transmitted diseases found in the UK. The disease is caused by the bacteria Chlamydia trachomatis and can not only cause problems for the vagina and penis, but can also be found in the cervix, rectum, throat and urethra.
In 2017, approximately 420,000 cases of Chlamydia were reported in the UK. In 2015, it was announced by the National Chlamydia Screening Programme that all sexually active men and women under the age of 25 should be screened at least once annually.
Chlamydia can affect both men and women and is typically transmitted through unprotected sexual intercourse (without a condom). It is more common in young people, particularly young women, but men can also be affected. Chlamydia can be passed onto sexual partners during oral, vaginal or anal sex with someone who has the infection and a woman can also pass the disease onto her baby during childbirth. It is also possible to be reinfected with chlamydia even if you have been treated in the past if you have unprotected sex with someone who has it.
As a bacterial infection, it can also be passed on through the following:
- Genital to genital contact with an infected person without penetration or ejaculation
- Sharing sex toys without cleaning them in between uses or not using a new condom each time they are used
- Eyes may be affected if they come into contact with infected vaginal fluid or semen
About 70% of infected females and 50% of males will not have any obvious signs or symptoms or they may be so mild they are not noticed.
If an individual is experiencing symptoms, however, these can include:
- Pain when urinating
- Unusual vaginal discharge, or discharge from the penis or rectum
- Stomach pain or pain in the pelvis
- Pain during sex for women
- Bleeding during or after sex for women
- Testicular pain in men
- Bleeding between periods or heavier periods
Symptoms may develop within a few days or weeks but can sometimes take months or even years to show.
Diagnosing chlamydia is relatively simple but may require a visit to your local GP, sexual health clinic or local genitourinary clinic (GUM). Due to the risk of other health issues which can be aligned with chlamydia, it is important to ask your doctor how often you should have screening tests carried out. Screening is often recommended for:#
Sexually active women aged 25 or younger – the risk of infection is highest in this group and as a result, annual screening is recommended. It is also recommended if you have a new sexual partner with whom you are having unprotected sex, even if you have been tested within the last year.
Pregnant women – Chlamydia in pregnancy can be serious and have potentially massive complications such as ectopic pregnancies, chronic pelvic pain and infertility and pregnant women who are infected with chlamydia have an increased risk of their waters breaking prematurely, causing the baby to be born early. There is also a risk that the mother may pass the infection onto the baby during childbirth, this is known as perinatal transmission.
Women & men at high risk: if you have multiple sexual partners and do not always use a condom, then you should consider having regular screening carried out. This is important for individuals of all sexual orientation.
There are a number of tests which can be carried out in order to diagnose chlamydia. These include:
A swab – this test is for women and can be performed during a routine Pap test. Your doctor will take a swab of the discharge from your cervix in order to test for chlamydia. Men may also be swabbed, with a slim swab inserted into the end of your penis in order to obtain a sample of the urethra. In some circumstances, the anus may be swabbed.
A urine test: a urine sample can be analyzed in the lab in order to determine if you have the infection.
Results may take 7-10 days to process.
Being diagnosed and undergoing chlamydia treatment promptly can help to prevent any complications of the infection. While annual testing is recommended for sexually active adults aged 25 and under, you may also want to be tested if:
- You are having unprotected sex with a new partner
- You or your partner have symptoms of chlamydia
- You or your partner are having unprotected sex with other people
- You or your partner have another STI
- The condom splits during sex
- You are pregnant or planning pregnancy
If left untreated or treated incorrectly, chlamydia can result in a number of complications. These include:
- Having an increased risk of contracting other STIs such as gonorrhoea and HIV
- Pelvic inflammatory disease (PID) which is an infection of the uterus and fallopian tubes in women. This can be a cause of ectopic pregnancy and infertility if left untreated.
- Reactive arthritis or Reiter’s syndrome
Chlamydia can usually be effectively treated using antibiotics. In more than 95% of cases, individuals will be cured successfully.
In the UK, the two most commonly prescribed chlamydia treatments are:
- Doxycycline: 100mg twice daily for 7 days
- Azithromycin: 1g dose given as a single dose, flowed by 500mg taken daily for two days
Both medications are useful at treating uncomplicated urogenital chlamydia infection. They are both antibiotics but work in different ways. The first is now recommended as a first line treatment whereas the latter is a useful alternative for those who are unable to tolerate Doxycycline or other Tetracycline antibiotics.
Treatment with antibiotics will usually be started following confirmation of the diagnosis via the test results. However, if Chlamydia infection is highly suspected, i.e. you have a number of the symptoms listed above, then you may need antibiotics before the test results come through.
It is important not to have any form of sexual intercourse (both with and without a condom) until both you and your partner(s) have completed treatment, as this will help to prevent the infection from being passed on.
If you had the short course of azithromycin to treat this infection, you should avoid having sexual intercourse for a week after treatment.
If you have tested positive for chlamydia, it is important to ensure that all of your sexual partners within the last six months have been tested and treated for the infection.
Sexual health and GUM clinics have specialized sexual health advisors who can help you contact your recent sexual partners and explain that they have been exposed to a sexually transmitted infection and therefore need to be tested promptly. Either you or the advisor can correspond with the individual exposed.