Answers to common questions about Chlamydia

Get the facts about Chlamydia. Here are the answers to some common questions about this sexually transmitted disease (STD).

What is chlamydia?

Chlamydia is a common and curable infection caused by the bacteria Chlamydia trachomatis. The bacteria target the cells of the mucous membranes, which are the soft, moist tissues of the body not covered by skin.

Examples of areas that could be infected with this bacteria include:

• the surfaces of the urethra,vagina, cervix and endometrium
• the fallopian tubes
• the anus and rectum
• the lining of the eyelid
• and less commonly, the throat.

How common is chlamydia?

In the United States, chlamydia is the most common bacterial sexually transmitted disease (STD), particularly among sexually active adolescents and young adults. In 2000, 702,093 cases of chlamydia were reported to the Centers for Disease Control and Prevention (CDC). However, it is estimated that 3 million cases actually occurred and as many as one in 10 adolescent females test positive for chlamydia.

How do people get chlamydia?

Chlmydia, like other sexually transmitted diseases (STDs) is passed from an infected person to a partner through certain sexual activities.

• Chlamydia is passed primarily during anal or vaginal sex. It is less likely to be transmitted through oral sex.
• It can be passed when the mucous membrane, the soft skin covering all the openings of the body, comes into contact with the mucous membrane secretions or semen of an infected person. This is what happens during unprotected sex (that is sex without a latex condom) whether vaginal or anal sex.
• Oral sex is not a common cause of infection with this bacteria. Chlamydia is less likely to be transmitted during oral sex because the bacteria that cause chlamydia prefer to target the genital area rather than the throat. This is why it is unlikely for chlamydia to be transmitted from mouth-to-penis and penis-to-mouth contact, although it is still possible. It is even less likely for transmission to take place from vagina-to-mouth or anus-to-mouth contact. Transmission is not known to occur from mouth-to-vagina and mouth to anus contact.
• Chlamydia can be passed even if the penis or tongue does not go all the way into the vagina or anus. If the vagina, cervix, anus, penis or mouth come in contact with infected secretions or fluids, then transmission is possible.
• Even a woman who has not had anal sex can get chlamydia in the anus or rectum if bacteria are spread from the vaginal area, such as when wiping with toilet paper.
• Eye infections may result when discharge caries the disease into the eye during sex or hand-to-eye contact.
• Chlamydia is not passed through things like shaking hands or toilet seats.
• Even if a person with chlamydia is treated and cured, they can be reinfected if they are exposed to chlamydia again.
• It can also be passed from mother to newborn as the baby passes through the infected birth canal. This can result in eye infections, pneumonia or other complications.
• In children, chlamydia may be a possible sign of sexual abuse.

What are the signs and symptoms of chlamydia?

If a person does have symptoms, they usually develop within one to three weeks after exposure to chlamydia. How long a person remains infectious (able to transmit the bacteria to others) is difficult to determine since so many people are asymptomatic. A person must be considered infectious from the time they become infected until treatment is completed.

• Men, women and infants
  • Both men and women can experience proctitis (inflamed rectum), urethritis (inflamed urethra) and conjunctivitis (inflamed eyelid).
  • Most infections of the mouth and throat are asymptomatic. If present, symptoms are soreness and redness in the throat or mouth.
  • The most common complications in newborns include conjunctivitis and pneumonia.
• Women
  • Most women do not experience any symptoms, but if symptoms are present they may be minor.
  • Symptoms may include:
    • vaginal discharge, or
    • burning sensation during urination.
  • If the infection spreads to the fallopian tubes, women may experience
    • lower abdominal and lower back pain,
    • pain during intercourse,
    • bleeding between menstrual periods, or
    • nausea or fever.
• Men
  • Men may be asymptomatic or symptoms may be minor. When men do have symptoms, they may experience one or more of the following:
    • pus (thick yellow-white fluid) or watery or milky discharge from the penis
    • pain or burning during urination
    • pain or swelling of the testicles

How can I find out if I have chlamydia?

There are several different reliable tests for chlamydia. It may be helpful to speak to your health care provider about what testing options are available.

People infected with chlamydia are often also infected with gonorrhea. Therefore, patients with chlamydia are often treated for gonorrhea at the same time, since the cost of treatment is less than the cost of testing.

What is the treatment for chlamydia?

There are antibiotic treatments that are effective in treating chlamydia. Which antibiotic is prescribed is decided by a health care provider, who will take into consideration the particular needs of the patient.

Whaterver treatment is prescribled, there are some important points about any treatment:

• The patient must take all medications as directed.
• All partners should be examined and treated.
• The infected person should not have sex until he or she and any partner or partners have been treated and cured.
• Persons who show symptoms after treatment should be tested again by culture.
• Infections detected after treatment with one of the recommended treatments more commonly occur because of reinfection rather than treatment failure.
• Women should be retested three to four months after treatment because of a high rate of reinfection.

Because the symptoms of chlamydia are similar to the symptom of gonorrhea, and because a person can be infected with both, the Centers for Disease Control and Prevention (CDC) recommends that people with chlamydia be treated for both diseases. Partners should be examined and treated as well.

What can I do to reduce my risk of getting chlamydia?

As with other sexually transmitted diseases (STDs) there are things people can do to reduce or eliminate the risk of chlamydia. Therse include the following:

• Abstinence (not having sex) is a sure way to avoid infection.
• Mutual monogamy (having sex with only one uninfected partner) is another way to avoid infection.
• Using latex condoms for vaginal and anal sex reduces risk.
• Water-based spermicides are not recommended for the prevention of chlamydia. Recent studies have shown that nonoxynol-9 (N-9), which is found in most water-based spermicides, is not effective in preventing chlamydia.
• Since chlamydia can be transmitted even if the penis or tongue does not completely enter the vagina, mouth or rectum, using latex condoms at the beginning of sexual contact until there is no longer skin contact is the best form of prevention.
• Several barrier methods can be used to reduce the risk of transmission of chlamydia during oral sex. A non-lubricated condom can be used for mouth-to-penis contact. Household plastic wrap, a dental dam, or a latex condom cut-up and opened flat can reduce the risk of transmission during mouth-to-vulva/vagina or oral-anal (rimming) contact.

Why worry about chlamydia?

If untreated, chlamydia can cause complications in men, women and infants.

• Untreated chlamydia infections in women may lead to:
  • Pelvic Inflammatory Disease (PID). (PID is a serious infection of a woman's reproductive organs. Left untreated, PID can cause infertility.)
  • Cystitis (inflammation of the urinary bladder)
  • A condition called mucopurulent cervicitis, characterized by a yellow discharge from the cervix
• Untreated chlamydia in men may lead to:
  • Prostatitis (inflammation of the prostate gland)
  • Scarring of the urethra
  • Infertility
  • Epididymitis (inflammation of the epididymis, which is the elongated, cord-like structure that runs along the back of each testes)

• Untreated chlamydia in infants may lead to:
  • Blindness
  • Complications of pneumonia, which can include death
• Reiter's Syndrome (RS)Reiter's syndrome is a disorder that causes 3 seemingly unrelated symptoms:
  1. arthritis (joint inflammation),
  2. redness of the eyes, and
  3. urinary tract problems.

  Chlamydia trachomatis is one of the bacteria that can cause RS.

  Most men and women with chlamydia do not develop RS. RS usually affects men between the ages of 20 and 40. Women can develop the disorder, though less often than men and with symptoms that are milder and less noticeable.

Do I need to talk to my partner about chlamydia?

Yes. Telling a partner can be hard, but keep in mind that most people with chlamydia do not know they have it. It is important that you talk to your partner as soon as possible so she or he can get treatment. Also, it is possible to pass chlamydia back and forth, so if you get treated and your partner does not, you may become infected again.

Should I talk to my health care provider about chlamydia?

Yes. Because chlamydia often does not have symptoms, you may need to talk to your doctor about whether or not you should be tested. If you are having unprotected sex or discover that your partner is having unprotected sex with another person, you may want to ask your doctor about being tested.