Definition

Chlamydia is one of the most common sexually transmitted diseases (STDs) in the United States.

Treatment includes antibiotics, partner notification, and lifestyle changes.

Causes

Chlamydia is caused by a bacterium that is transmitted from an infected partner during sex. This can happen during oral, vaginal, or anal sex.

Risk Factors

Chlamydia is most common among sexually active teens and young adults. Other factors that increase your chances of getting chlamydia include:

• Being sexually active
• Multiple sexual partners
• Having sex without a condom
• History of STDs

Symptoms

Most people who have chlamydia do not have symptoms. If symptoms do occur, they might appear within 1-3 weeks of exposure.

Symptoms in men may include:

• Discharge of pus from the penis
• Burning, itchy, or painful sensation while urinating

Symptoms in women may include:

• Increased or abnormal vaginal discharge
• Vaginal redness or irritation
• Painful and frequent urination
• Unusual vaginal bleeding, or bleeding between periods
• Pain or bleeding during or after sex
• Abdominal pain

Pregnant women can transmit chlamydia to their newborns during birth. This may cause conjunctivitis or pneumonia in the baby. Identification and treatment during pregnancy can greatly reduce risks for the baby.

Chlamydia can also cause serious health complications.

Complications in men include:

• Epididymitis —A painful swelling and inflammation of the testicles, which may lead to infertility.
• Urethritis —The inside of the urethra may become inflamed, which causes burning when passing urine. If scarring occurs, it may cause difficulty with passing urine or block urine flow completely.
• Prostatitis —An inflammation of the prostate gland. Symptoms include pain in and around the groin and pelvis, or discomfort when urinating. It may also create flu-like symptoms, such as fever, chills, body aches, or fatigue.
• Reiter’s syndrome —A triad of urethritis, arthritis, and conjunctivitis.

Complications in women include:

• Pelvic inflammatory disease (PID)—A serious infection that can lead to infertility, even in women who never have symptoms. If symptoms do occur, they may include pelvic pain and pain with intercourse. PID causes scar tissue, or may cause an abscess to form in the fallopian tubes.
• Tubal pregnancy —Scarring in the fallopian tube also increases the risk of a tubal pregnancy and infertility. A tubal pregnancy occurs when a fertilized egg cannot reach the uterus. It is a serious condition that may cause a rupture, bleeding, or infection inside the abdomen. A ruptured or bleeding tubal pregnancy is considered a surgical emergency.
• Abdominal inflammation—Chlamydia and gonorrhea may cause inflammation around the reproductive organs, the appendix, or the liver. When the liver is involved, symptoms resemble gallbladder disease, with fever and pain under the right ribs. This condition is called Fitz-Hugh-Curtis syndrome.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is based on tests.

Your bodily fluids will be tested. This can be done with:

• A swab of the discharge from the penis, cervix, throat, or rectum
• Urine tests

You may be tested for other STDs, such as:

• Gonorrhea
• Syphilis
• HIV

Treatment

Chlamydia is treated with antibiotics.

To ensure successful treatment:

• It is important that you and your partner both be treated. Wait at least 7 days before you have sex again.
• If you still have symptoms after the medication is finished, or if you are pregnant, you may need to be tested again.
• You should be tested again 3 months after treatment to make sure you have not been reinfected.

Prevention

To reduce the chances of getting chlamydia, take these steps:

• Always use a latex condom during sexual activity.
• Have routine check-ups for STDs if you are a woman under the age of 25. Sexually active young men should consider screening, although there is no specific guideline.
• Have check-ups often if you have other risk factors for getting STDs.
• Have a monogamous relationship. Monogamous means only one sexual partner.

Women’s Health—US Department of Health and Human Services http://www.womenshealth.gov

Sex Information and Education Council of Canada http://www.sieccan.org

Chlamydia. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/std/chlamydia/default.htm
Updated December 16, 2014. Accessed May 28, 2015.

Chlamydia genital infection. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated March 11, 2015. Accessed May 28, 2015.

Chlamydia fact sheet. Women’s Health—US Department of Health and Human Services website. Available at:
http://www.womenshealth.gov/publications/our-publications/fact-sheet/chlamydia.html
Updated July 8, 2011. Accessed May 28, 2015.

Gottlieb SL, Martin DH, et al. Summary: The natural history and immunobiology of Chlamydia trachomatis genital infection and implications for Chlamydia control. J Infect Dis. 2010;201:Suppl 2:S190-204.

Kent CK, Chaw JK, et al. Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis. 2005;41:67-74.

Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

3/17/2015 DynaMed’s Systematic Literature Surveillance
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U.S. Preventive Services Task Force. Screening for chlamydia and gonorrhea: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Dec 16;161(12):902-10.