Chlamydia (pronounced clam-id-ee-a) is a sexually transmitted infection. Officially, it is a bacterium, but it is more like a virus in being very small and unable to multiply outside living cells. Chlamydia is not life-threatening, but it can do serious damage to a woman’s Fallopian tubes. If this happens, the woman could become infertile (unable to become pregnant). The results of chlamydia infection cost the NHS in the UK about £50 million a year.
Is chlamydia common?
In the UK and USA, chlamydia is the commonest sexually transmitted infection.
- In 2007, 121,986 new cases were seen at sexual health clinics in England, Scotland and Northern Ireland. This is an 7% rise compared with 2006.
- Of those affected, 65% were in the 16–24-year age group.
- Chlamydia is not just a disease of young people; it is increasing in older age groups as well as in young people.
How you get chlamydia
How do you know if you have chlamydia?
- About 50% of men with chlamydia have no symptoms, and do not know that they have the infection. In the other 50%, chlamydia irritates the urethra (the tube inside the penis), causing a discharge and making it painful to pass urine. Occasionally (in about 2% of cases), chlamydia spreads to the testicle (usually only on one side), where it causes pain and inflammation; some doctors think that if this happens, the man’s fertility could be affected.
- In women, chlamydia infection is usually completely silent, so they are unaware that they have it – 80% of women with chlamydia have no symptoms at all. Some women notice a slightly increased discharge, or slight bleeding between periods or after sex. If it has reached the Fallopian tubes (see below), it can cause pain in the lower part of the abdomen (tummy).
- Some men (and a few women) develop ‘Reiter’s syndrome’. This is a reaction to the chlamydia bacterium, and consists of painful joints (usually knees or ankles) and sore eyes (conjunctivitis). It normally clears up within 6 months, but may keep recurring over several years, even if you never get chlamydia again. Whether or not you develop Reiter’s syndrome depends more on your genes than on the severity of your chlamydial infection.
Tests for chlamydia
- In women, the cervix (neck of the womb) is wiped with a cotton wool bud, which is then sent to the laboratory for testing. To do this test, the doctor or nurse will insert a speculum into the vagina, like having a smear test. In men, the cotton wool bud is inserted into the end of the urethra (pee hole) to obtain the sample.
- A urine sample can be tested. However, this test is not available everywhere and, for women, it is not as reliable as taking a sample from the cervix. For this test you must hold your urine for at least an hour beforehand.
- A sample from the vagina in women can be tested using a new more accurate test (nucleic acid amplification test, NNAT). This means that women could take their own samples.
When to have a chlamydia test
- if you have symptoms, such as discharge or lower abdominal pain (women), pain on passing urine (men) or pain in the testicles (men)
- if your partner has symptoms
- if you had sex with a new partner without a condom in the past year
- if your partner has had a chlamydia infection and you are not sure if he/she was properly treated
- if you had treatment for a chlamydia infection, but your partner did not have treatment
- if you and your partner had treatment for a chlamydia infection, but had sex before the treatment was completed
- if you have another sexually transmitted infection (such as genital warts)
- if you are about to have a termination of pregnancy (abortion).
What happens if chlamydia infection is not treated?
Pelvic inflammatory disease
- If 100 women get a chlamydia infection, 20 will develop PID.
- Of these 20 who develop PID, 2 will have difficulty conceiving and 1 will have an ectopic pregnancy.
- The more times a woman has PID, the greater the damage to the tubes and the greater the chance of later problems. So if those 20 women had another attack of PID, 4 would become infertile and 2 would have ectopic pregnancies.
- If those same 20 women had three or more attacks of PID, 8 or 9 would become infertile and 4 would have ectopic pregnancies.
Treatment for chlamydia and talking to your partner
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Thursday, June 10th 2010
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