Chlamydia
What Is Chlamydia? Symptoms, Testing and Treatment
Chlamydia is an infection caused by the bacterium Chlamydia trachomatis that can be transmitted through sexual contact. It can affect both women and men. As the infection often causes no symptoms, a person may pass it on to their partner without knowing it.
How is chlamydia transmitted?
Chlamydia can be transmitted during vaginal, anal or oral sexual contact. Transmission is possible even without symptoms. Successful treatment does not provide immunity against the infection; it can be acquired again following re-exposure.
What are the symptoms?
Chlamydia causes no symptoms in most people. If symptoms develop, women may experience vaginal discharge, burning when urinating, pain during sexual intercourse, bleeding between periods or lower abdominal pain. Men may experience discharge from the penis, burning when urinating or testicular pain. Anal infection may cause pain, discharge or bleeding. As these symptoms may also be associated with other conditions, testing and a medical assessment are necessary.
How is chlamydia testing performed?
The most commonly used method for diagnosing chlamydia is a NAAT/PCR test, which detects the bacterium's genetic material. The sample is selected according to the anatomical site where infection is suspected:
- For women, usually a vaginal swab; in some cases, a first-catch urine sample
- For men, usually a first-catch urine sample
- If anal or oral contact has occurred, a swab from the relevant site, based on the doctor's assessment
A urine or genital sample does not always rule out an anal or throat infection; the sampling site should be determined based on the history of sexual contact. At Wellcare Laboratories, chlamydia testing is available as part of the STI PCR test panel. The appropriate sample type is determined by the requested test and the laboratory's sample acceptance requirements.
Who should consider getting tested?
The CDC recommends annual chlamydia screening for sexually active women under 25, and testing for women aged 25 and over who have risk factors such as a new partner, multiple partners or a partner diagnosed with an STI. For men who have sex with men, people living with HIV and those seeking an STI assessment, testing frequency and sampling sites are planned according to individual risk and history of sexual contact. Screening during pregnancy is also based on age and risk factors.
Can chlamydia be treated?
Yes. Chlamydia can be cured with appropriate antibiotic treatment. The CDC generally recommends doxycycline as the first-line treatment for non-pregnant adults; a different medication is used during pregnancy. The medication and duration of treatment should be determined by a doctor. Treatment does not always reverse existing damage that the infection may have caused, so it is important not to delay testing and treatment.
Sexual contact should be avoided until treatment has been completed and partners have also been treated. If a single-dose treatment is given, the CDC recommends waiting at least 7 days. Assessment and, if necessary, treatment of sexual partners from the past 60 days reduce the risk of reinfection.
Is retesting needed after treatment?
For non-pregnant individuals who have fully adhered to treatment and whose symptoms have resolved, a routine “test of cure” immediately after treatment is generally not recommended. A NAAT/PCR test performed too early may detect remnants of non-viable bacteria and give a positive result. However, to detect reinfection, people who have been treated are advised to get retested approximately 3 months later. During pregnancy, a test approximately 4 weeks after treatment is needed to confirm cure, followed by repeat testing.
What can happen if chlamydia is left untreated?
Untreated chlamydia can cause pelvic inflammatory disease and damage to the fallopian tubes in women; this may increase the risk of ectopic pregnancy and infertility. Men may develop inflammation of the epididymis. During pregnancy, transmission of the infection to the baby during delivery can cause an eye infection or pneumonia in the newborn.
Preventing chlamydia
Correct and consistent condom use reduces the risk of transmission. Discussing testing and protection before having sex with a new partner, as well as getting tested at the recommended intervals, can help detect the infection early.