Chlamydia

Known as a silent disease, early symptoms of chlamydia often go unnoticed. But if left untreated, the disease can seriously damage the reproductive organs. Find out what causes chlamydia, the symptoms to look out for, and how to treat this sexually transmitted infection.

What is Chlamydia?  

A chlamydia infection is caused by the bacterium Chlamydia trachomatis, which can be transmitted via vaginal, anal or oral sexual intercourse. 

Any sexually active person may get infected with chlamydia through contact with mucous membranes of vagina, urethra, rectum or mouth. An infected mother can also pass chlamydia to her baby during vaginal delivery.

The risk of infection increases with unprotected sex, multiple sexual partners and those who engage in oral or anal sex. Sexually active teenage girls and young women are more prone to develop chlamydial infection as the opening of the uterus (cervix) is not fully matured; this also increases their risk of developing other STIs such as gonorrhoea and syphilis.

Symptoms

Symptoms of early infection often go unnoticed or fail to appear. Hence, chlamydial infection is rightly known as a silent disease. When chlamydia symptoms do occur, they are usually mild and start to show between one to three weeks after exposure to the bacteria.

Symptoms include:
Burning sensation or pain while urinating
Abnormal vaginal discharge in women
Painful sexual intercourse in women
Lower abdominal or back pain
Bleeding after sexual intercourse or between menstrual periods in women
Penile discharge and itching around penis in men
Rectal pain and discharge (anal sex)
Rarely, testicular pain and swelling in men

A type of Chlamydia trachomatis can cause another sexually-transmitted infection (STI) called lymphogranuloma venereum. The symptoms of this infection include genital sores followed by fever and swelling of the lymph nodes in the groin.

Complications

Untreated chlamydia infections may progress to serious damage of the reproductive organs along with other health problems.
Chlamydia may cause pelvic inflammatory disease (PID) without any symptoms in up to 40 percent of women. PID may result in chronic pelvic pain, infertility and ectopic pregnancy (pregnancy outside uterus) due to permanent scarring of the fallopian tubes. Women infected with chlamydia are up to five times more at risk of acquiring HIV Infection if exposed
Infection during pregnancy can result in premature delivery and stillbirth. An infected mother can also pass the infection on to her baby during vaginal delivery resulting in pneumonia (lung infection) or conjunctivitis (eye infection)
Chlamydia complications and infection may spread to the rectum and result in inflammation, discharge and pain
In some individuals, severe conjuntivitis (eye infection) may occur if the eyes become contaminated with infectious secretions
Rarely, infection can spread to the epididymis (tube carrying sperm from the testes) resulting in fever, scrotal pain, swelling and sterility in men
Very rarely, chlamydial infection may cause inflammation of the joints (arthritis) accompanied by lesions on the skin and inflammation of the eye and urethra (Reiter's syndrome)

Diagnosis and Screening  

Annual screening for chlamydia symptoms and other STIs is recommended for all those who are sexually active.
Women and men with multiple sex partners, a new sex partner, or engaging in unprotected sex should consider regular screening
All pregnant women should be tested for chlamydia during their first prenatal visit and thereafter, if there is risk of infection from their regular partner

Tests for diagnosis include:
Urine test to check for the presence of bacteria
Swab specimen of the discharge from the infected site (cervix for women and penis for men) for culture to isolate the bacteria or to check for the antigens that bacteria produce in the body
The polymerase chain reaction (PCR) test to identify the bacteria in cells and secretions from the genital tracts

Treatment

Chlamydia infection can be effectively treated with antibiotics. A single dose of oral Azithromycin or Doxycycline twice daily for one week is most commonly prescribed as chlamydia treatment. An alternative drug (erythromycin) may be prescribed for those who are pregnant or younger than 18 years of age.

The infection usually resolves within one to two weeks. Retesting after chlamydia treatment should still be considered if one has a new sex partner or is unsure of the partner's treatment status.

How can I protect myself? 

The best way to prevent the infection is to abstain from unprotected sex and to be faithful to your partner.

Some measures to reduce the risk of transmission are:
Using condoms consistently and correctly to reduce the chances of infection
Refraining from having sex until your infection is completely cured
Notifying your partner(s) if you have the infection so that they can also be tested and receive treatment if necessary
Limiting your sexual partners and getting screened regularly

You can get yourself tested for STIs at private clinics, polyclinics and hospitals. In addition, some private clinics and hospitals provide STI testing.

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