Chlamydia Questions and Answers

One out of four Americans between 15 and 55 will catch at least one sexually transmitted infection (STI).

Chlamydia is the most common of more than 30 different STIs in America today. Four million women and men get Chlamydia every year, but many people don’t know it exists.

Although it is normal and healthy for people to enjoy active sex lives, many people find sex and sexual health very difficult to talk about. Please don't let embarrassment become a health risk. Speak frankly about your sex life and your sexual health concerns with your partner and your health care clinician.

Don't wait for your clinician to ask-take charge, speak up, and ask questions.

Planned Parenthood wants you to have a happy and healthy sex life. The key is to know the facts, understand your risks, and take precautions.

Contents:

• What is Chlamydia?

• What are the symptoms of Chlamydia?

• How is Chlamydia spread?

• How many people have Chlamydia?

• Is Chlamydia dangerous?

• How does Chlamydia affect pregnancy?

• How is Chlamydia diagnosed?

• Is there a cure of Chlamydia?

• Who is most likely to get Chlamydia?

• How can people with Chlamydia avoid spreading it?

• How can I avoid getting Chlamydia?

• Does using birth control increase my risk of getting Chlamydia?

• Where can I get tested and treated for Chlamydia?

What is Chlamydia?
Chlamydia (klah-MIH-dee-ah) is the most common sexually transmitted infection in the U.S. Its full name is Chlamydia trachomatis (trah-ko-MAH-tis). It is a bacteria that can infect mucus membranes in the penis, vagina, cervix, anus, urethra, or eye.

Chlamydia is the name of several types of bacteria. Chlamydia trachoma, for example, has been a major cause of blindness for centuries. Chlamydia trachomatis is one of two kinds of Chlamydia that are sexually transmitted. The other, lymphogranuloma venereum, occurs primarily in the tropics. In the U.S., we simply refer to Chlamydia trachomatis as "Chlamydia."

What are the symptoms of Chlamydia?
Usually, Chlamydia has no symptoms. This is true for 80 percent of the women and 10 percent of the men with Chlamydia. When symptoms occur, they may begin in as little as five to 10 days after infection.

When women have symptoms, they include:

• bleeding between menstrual periods

• vaginal bleeding after intercourse

• abdominal pain

• painful intercourse

• low-grade fever

• painful urination

• the urge to urinate more than usual

• cervical inflammation

• abnormal vaginal discharge

• mucopurulent cervicitis (MPC)-a yellowish discharge from the cervix that may have a foul odor.

When men have symptoms, they include:

• pus or watery or milky discharge from the penis

• pain or burning feeling while urinating.

These symptoms are very like the symptoms of gonorrhea. They are called nongonococcal urethritis (NGU). Men often don't take these symptoms seriously because the symptoms may only appear early in the day and can be very mild.

In women and men, Chlamydia may affect the rectum causing itching, bleeding, mucus discharge, and diarrhea. It may also cause redness, itching, and discharges of the eyes if they become infected.

How is Chlamydia spread?
Chlamydia is spread by vaginal and anal intercourse. It can also spread from a woman to her fetus during birth.

How many people have Chlamydia?
About four million American women and men become infected with Chlamydia every year. Chlamydia is:

• four times as common as gonorrhea

• more than 30 times as common as syphilis

• most common among women and men under 25.

New cases of Chlamydia outnumber new cases of herpes six to one.

Is Chlamydia dangerous?
Untreated, Chlamydia is a serious health threat, especially for women.

In women, Chlamydia infections usually begin on the cervix. Unless treated, they may spread to the fallopian tubes or ovaries and result in pelvic inflammatory disease (PID). Between 250,000 and 500,000 cases of PID are caused by Chlamydia every year in the U.S.

PID can cause sterility by scarring and blocking the fallopian tubes. Partly blocked tubes may cause ectopic pregnancies by preventing fertilized eggs from reaching the uterus. A woman may die if a pregnancy develops outside her uterus. This life-threatening condition usually requires surgery. Women with PID of the fallopian tubes are seven to 10 times more likely to have ectopic pregnancies than other women.

The symptoms of PID include:

• longer and/or heavier periods

• more cramping during periods

• abnormal mucus discharges

• pain in lower abdomen

• tiredness, weakness

• fever

• vomiting

• pain during vaginal intercourse.

Chlamydia can also cause sterility in men. It causes a condition called epididymitis if it spreads from the urethra to the testicles. Untreated, epididymitis causes sterility. More than 250,000 cases of acute epididymitis caused by Chlamydia are reported in the U.S. every year. Symptoms of epididymitis include:

• fever

• swelling and extreme pain in the scrotum.

Chlamydia may also cause Reiter's syndrome-usually in young men. Symptoms include:

• eye infections

• urethritis

• arthritis.

The recurrence of arthritis becomes a disability for one out of three men who develop Reiter’s syndrome.

How does Chlamydia affect pregnancy?
Between 20 and 50 percent of the children born to women with Chlamydia will also be infected. Every year, more than 180,000 newborn infants suffer eye infections and pneumonia as a result of being born to women with Chlamydia. Symptoms usually begin within four weeks of birth.

Children who were infected at birth may develop ear infections, eye infections that can cause blindness, and a kind of pneumonia that can be fatal. Ear and respiratory infections caused by Chlamydia in infants are harder to treat than Chlamydia infections in adults.

As well as infecting the newborn, Chlamydia infections may cause heavy bleeding before delivery. There are some indications that Chlamydia also causes premature rupture of the membranes and premature delivery. Chlamydia infections may also be associated with miscarriage, stillbirth, or low infant birthweight.

Treatment of Chlamydia is successful in 90 percent of pregnant women.

How is Chlamydia diagnosed?

• examination of the cervix and of cervical discharge

• laboratory culture or chemical tests of cells taken from the penis, cervix, urethra, or anus.

Pap tests may indicate if tests for Chlamydia are appropriate, but cannot diagnose Chlamydia by themselves.

Gonorrhea and Chlamydia have similar symptoms. It is important to tell them apart because penicillin has no effect on Chlamydia but it can kill gonorrhea. Other sexually transmitted infections (STIs) may also mask the symptoms of Chlamydia.

Is there a cure for Chlamydia?
Yes. Chlamydia is easy to treat. Both partners must be treated at the same time. Antibiotics kill Chlamydia bacteria. Doxycycline is usually prescribed. Tetracycline and Zithromax® are also effective. Erythromycin is often prescribed for pregnant women and other people who cannot take tetracycline. Erythromycin is also used to treat infants with eye infections or pneumonia caused by Chlamydia. Your clinician can help you decide which treatment is best for you and your partner.

Medication is also the most common treatment for PID. Surgery may be necessary to remove pelvic abscesses, scar tissue, or blockages in women who develop PID. However, sterility caused by Chlamydia often is permanent.

If you are treated for Chlamydia, or any other STI, remember:

• Take all the prescribed medicine. Even if the symptoms go away, the infection may still be in your body.

• Schedule follow-up visits to make sure you've been cured before you have sex again.

• Make sure your partner is treated at the same time so you don't re-infect each other.

• Do not share your medicine with anyone.

Who is most likely to get Chlamydia?

• people who have a number of different sex partners

• people whose sex partners have a number of different sex partners

• people who don't use condoms

• people with a history of other STIs

• sexually abused children.

Young adults have the highest rates of Chlamydia.

How can people with Chlamydia avoid spreading it?

• Inform sex partners of the infection.

• Have no sex until treatment is complete.

• Be sure sex partners are screened and treated at the same time.

• Use condoms every time.

Anyone with a sex partner who has NGU, MPC, or acute PID, should be examined for Chlamydia as well as other STIs.

If a pregnant woman thinks that she or her partner has Chlamydia, she should inform her clinician immediately.

How can I avoid getting Chlamydia?

• Use a condom every time.

• Have routine checkups for STIs.

• Abstain from sexual intercourse.

Does using birth control increase my risk of getting Chlamydia?
The only methods that offer protection against Chlamydia are the condom and vaginal pouch. The Pill, Norplant® , Depo-Provera® , IUD, sterilization, periodic abstinence, and withdrawal do not protect against Chlamydia. The spermicide used with diaphragms, cervical caps, and contraceptive foams, gels, and suppositories may offer some protection against Chlamydia.

Women who contract Chlamydia while using the IUD are at higher risk of developing PID. That is why only women in stable, monogamous relationships are advised to use the IUD.

There is some evidence that hormones in the birth control pill may change the cervix in ways that make it more susceptible to Chlamydia infections. However, users of the Pill do not have an increased risk of developing PID from Chlamydia. In any case, women who use the Pill should also use a condom with partners who may have STIs.

Where can I get tested and treated for Chlamydia?
You can be tested and receive treatment and counseling from Planned Parenthood or other family planning health centers, private doctors, STI clinics, hospital clinics, and health departments.

References:

Text adapted from Chlamydia: Questions and Answers

© Revised version September 1995 Planned Parenthood® Federation of America Inc.

Copyright 1986 PPFA. All rights reserved.

Planned Parenthood® and its logo of "nested Ps" are registered service marks of PPFA.