Chlamydia is the most frequently reported sexually transmitted disease (STD) in the U.S., affecting an estimated three million people a year. The majority are teens and young adults, but some are older adults. It’s three times more common in women than men.
The good news is that because chlamydia is caused by a bacterium, it can easily be cured with antibiotics. The bad news is that you may not know you have it unless you get tested, because there may be few, if any, symptoms. About 75 percent of women and 50 percent of men have no symptoms at all.
Chlamydia is transmitted through contact with infected mucous membranes of a partner during vaginal or anal sex, and more rarely, oral sex. If there are symptoms, they generally develop one to three weeks later and are usually mild. Men with chlamydia may experience urethral discharge and pain when urinating. Women may have vaginal discharge, burning with urination, pain during intercourse, abdominal or low back pain, nausea, fever and bleeding between periods. Less often, there may be rectal pain, discharge or bleeding in both men and women from anal intercourse.
The hidden dangers
Chlamydia can have serious long-term consequences. In women the bacteria can primarily infect the cervix and eventually make their way to the fallopian tubes, leading to pelvic inflammatory disease, or PID. This can cause chronic pelvic pain, ectopic (or tubal) pregnancies (which result in miscarriage or even death of the mother) and infertility. Up to 40 percentof untreated women with chlamydia get PID, and as many as half of all cases of PID can be blamed on chlamydia. That makes chlamydia a leading cause of infertility in women. Women with chlamydia are also more likely to become infected if exposed to the HIV virus.
Complications of chlamydia in men, though less common, include inflammation of the epididymis (the tube that stores and transports sperm) and the prostate and scarring of the urethra. Whether chlamydia affects fertility in men is still unclear.
Recommendations, treatment, prevention
It may not be easy to discuss your sexual history with your healthcare provider, but it’s important to do so, especially if you have any symptoms that could indicate an STD. Annual screening for chlamydia is recommended for all sexually active women 25 and younger and for older women at increased risk (those with a new sexual partner or multiple partners).
Pregnant women should be tested because chlamydia can infect a baby during vaginal delivery and cause eye infections and even pneumonia. Men who have unprotected sex should also be tested.
If you’re having problems conceiving, chlamydia testing should be part of a routine fertility workup. To test for chlamydia, the doctor will swab the cervix (sometimes a woman can do this herself) or, in men, the urethra, or simply ask for a urine sample.
If you test positive, many safe and effective antibiotics are available. Aside from abstinence, the surest way to avoid chlamydia is to be in a monogamous relationship with a partner who is not infected.
Otherwise, use a latex condom every time you have intercourse: consistent use has been found to be about 90 percentprotective against chlamydia. Do not count on spermicides or a diaphragm for preventing chlamydia or other STDs. Oral contraceptives also do not protect against STDs.
Keep in mind: Prevention is always better than treatment. If you are a parent of an adolescent, be sure to talk about prevention. But early diagnosis of chlamydia and treatment with antibiotics can cure the infection and avert serious complications.