In at least 70% of women and 50% of men with chlamydia, there are no symptoms. You can be infected with chlamydia for months, even years, and can be passed on to others without knowing.
However, if you notice any of the following, then it is important to be tested for chlamydia.
- Bleeding between periods.
- Bleeding after sex.
- Pain during sex.
- Increase or unusual virginal discharge.
- Burning or discomfort when passing urine.
- Lower abdominal (pelvic) pain.
- Pain or burning when passing urine.
- Discharge from the penis.
- Discomfort in the urethra.
- Pain, swelling and tenderness of the testicular area.
Common Reasons for Requesting Treatment
If you have a positive chlamydia test result, either a swab or a urine test.
Intercourse with partner who has been tested positive for chlamydia
Antibiotic treatment should be started promptly if tested positive for chlamydia with either Azithromycin or Doxycycline.
They are both effective forms of treatment that have a high cure rate. There is no difference in adverse effects or efficacy found between the two choices.12
Over 95% of people who take their antibiotics correctly will be cured of the infection.
Please visit the following sites for further information regarding the medication:
Five Step Plan for Chlamydia
1. Antibiotic: Complete the antibiotic prescribed, as soon as possible
2. Partner notification: Your current partner and any from the last three months should also have treatment for chlamydia.
3. Avoid sex for 7 days: You and your partner need to avoid sex for seven days from the first day of the antibiotic treatment.
4. Attend a GUM clinic for the screening of STIs: We advise that you also visit a GUM clinic to be screened for other sexually transmitted diseases.
5. Repeat the test 3-12 months later: Repeat the test to check for re-infection between 3-12 months, or sooner if there is a change of partner.
It is recommended that you visit a GUM /sexual health clinic for screening of other sexually transmitted infections including gonorrhoea, hepatitis B, HIV, and
syphilis. This should be done at least 1 week after completing treatment. Your current partner should be treated as well regardless of any test result. 3,5
It is important that previous partners (from the last 6 months are notified), you may choose to do this, or it can be done anonymously through a GUM clinic. 6 This to help reduce the spread of chlamydia.
It is advised that sexual intercourse with or without condoms (including oral sex) is avoided for 7 days after the treatment is started, as this is how long it takes for the infection to clear. By following this, you reduce your chances of the treatment not working or becoming re-infected.
If you have a coil (IUD or IUS) then uncomplicated genital Chlamydia infection does not require removal of it.3
If you are under 25, then you are at a higher risk of catching Chlamydia again. You should have a retest done at 3 months.
Young people are at a greater risk of acquiring chlamydia, however, it can occur at any age. Ideally, young sexually active people should be screened for chlamydia every year. In 2014 there were 206,774 new diagnoses of chlamydia infection, and 70% of those were under 25.2
It is caused by the chlamydia bacteria spreading from one person to another through unprotected vaginal, anal or oral sex.
It can also spread through contact with infected vaginal fluids or semen. It cannot be passed through kissing or hugging.
It can also pass from a pregnant woman to her baby.
When To Seek Further Advice
You may need to seek further advice from a GP or GUM clinic if any of the following apply:
You had sex before you and your partner finish treatment
You forgot to take your medication or didn’t take it properly
If your symptoms don’t go away
You were treated for chlamydia whilst pregnant
The following tests can be done to confirm the diagnosis, which includes either a urine test (FCU)* or a swab. 3,5
You can be tested at (or obtain free and confidential chlamydia self-testing kits from):
your GP practice
a local GUM (sexual health) clinic
You can also buy chlamydia testing kits from your pharmacy.
A test of cure after treatment is not usually necessary, except in pregnant women.1 Repeat testing is advisable after 3-6 months to check for re-infection especially in those under the age of 25, and who are at high risk of re-infection.1
*(FCU)- first-catch urine sample. Do not empty your bladder for at least 1 hour before the test, then catch the first sample of urine you pass from your bladder.
If left untreated then the infection may spread and cause problems in other parts of the body, leading to long-term health problems. This is why you should consider regular testing and ensure you are treated quickly.
Pelvic Inflammatory disease (PID) occurs in 16% of women with untreated chlamydia. PID can increase the risk of infertility, ectopic pregnancy, and chronic pelvic pain. Women with one episode PID may cause tubal infertility in up to 18% of those, affected, as suggested in one review.9
Epididymo-orchitis (pain and inflammation of the epididymis and testes). Some studies suggest a possible association with male infertility, but the evidence for this is not conclusive.10,11
In males and females
Chlamydia can also cause sexually acquired reactive arthritis. It can affect about 1% of men but is rare in women.
Chlamydia can infect the eyes causing conjunctivitis which can cause eye redness, pain, and discharge.
It can infect the rectum (with unprotected anal sex) leading to discomfort and discharge from your rectum.
Chlamydia in pregnancy
There is a greater risk of premature rupture of membranes and a low birth weight if a woman has chlamydia during pregnancy. There is also a risk of the baby developing chlamydia conjunctivitis if the infection is left untreated.
NICE CKS: Chlamydia – uncomplicated genital June 2006
Public Health England PHE, 2015
British Association for Sexual Health and HIV (BASHH) 2015 UK national guideline for the management of infection with Chlamydia trachomatis, [BASHH, 2015].
Scottish Intercollegiate Guidelines Network (SIGN) guideline Management of genital Chlamydia trachomatis infection [SIGN, 2009].
Royal College of General Practitioners (RCGP) guideline Sexually Transmitted Infections in Primary Care [RCGP, 2013].
Health Protection Agency guideline on Diagnosis of Chlamydia trachomatis, Quick Reference Guide for General Practices [HPA, 2008].
BNF 71 (2016) British National Formulary.
Schembri G, Schober P. Risk factors for chlamydial infection in chlamydia contacts: a questionnaire-based study. J Fam Plann Reprod Health Care 2011; 37(1): 10-16.
Haggerty CL, Gottlieb SL, Taylor BD et al. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis 2010 Jun 15; 201 Suppl 2: S134-55.
Bezold G, Politch JA, Kiviat NB, et al. Prevalence of sexually transmissible pathogens in semen from asymp- tomatic male infertility patients with and without leuko- cytospermia. Fertil Steril 2007; 87: 1087–1097.
Joki-Korpela P, Sahrakorpi N, Halttunen M, et al. The role of Chlamydia trachomatis infection in male infertility. Fertil Steril 2009; 91(4 Suppl): 1448–1450.
Lau Cy, Qureshi AK. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Sex Transm Dis 2002;29(9):497-502.