Chlamydia: The “Silent” Sexually Transmitted Disease

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Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. (1) It is known as the “silent” disease because most infected individuals do not have symptoms. One in four infected males is asymptomatic. An estimated 30 percent of women with chlamydia have symptoms. (2)

Irreversible damage to a woman’s reproductive organs can occur before she is aware that she is infected. Untreated, chlamydia poses a greater threat for serious health complications in women than in men. Awareness of transmission and prevention of the infection is vital for all sexually active individuals.

How is Chlamydia Spread?

The infection is caused by the bacterium, Chlamydia trachomatis. The bacteria are spread during vaginal, oral and anal sex. It can be transmitted from an infected mother to her baby during vaginal childbirth.

Who is at Risk?

Any sexually active person is at risk. Your risk of infection increases if you have multiple sexual partners. Teenage girls and young women are at particularly high risk. The cervix or opening to the uterus is not fully matured and probably more susceptible to infection.

What are the Symptoms?

In women, Chlamydia trachomatis initially infects the cervix and the urethra. The urethra is the tube which carries urine from the bladder to the outside of the body. Women, who have symptoms, might have an abnormal vaginal discharge or a burning sensation when urinating.

If the infection spreads to the fallopian tubes, a woman with symptoms may experience lower abdominal pain, low back pain, nausea, fever, pain during intercourse or bleeding between menstrual periods. Chlamydia can spread to the rectum.

In men, chlamydia causes a discharge from the penis or a burning sensation when urinating. They might have itching and burning around the opening of the penis. In rare cases, there is pain and swelling of the testicles.

Women and men, who have receptive anal intercourse, can acquire a chlamydial infection in the rectum. The infection causes rectal pain, discharge and bleeding. Chlamydia is found in the throats of men and women who have oral sex with an infected person.

How is Chlamydia Diagnosed?

The most definitive test to diagnose chlamydia uses a sample of secretions from the infected person’s genital area. The specimen is sent to a laboratory where it is grown in a specialized tissue culture and analyzed under a microscope. Newer and less expensive tests detect chlamydia from urine and genital secretions. These tests are very accurate and results are available within two to three days. (3)

How is Chlamydia Treated?

Antibiotics easily treat and cure the infection. The most commonly used treatments include a single dose of azithromycin or a seven day course of doxycycline taken twice a day.

All sex partners should be evaluated, tested and treated. The CDC advises individuals infected with chlamydia to abstain from sexual intercourse for seven days following a single dose of antibiotic or until the completion of a seven day course of antibiotics. This prevents the transmission of the infection to sexual partners.

Women and men with chlamydia should be retested about three months after treatment of the initial infection, regardless of whether they believe that their sex partners have been treated.

Women, whose sex partners have not been properly treated, are at high risk for reinfection. Multiple infections increase the chance of serious reproductive health conditions such as infertility.

What are the Complications of Untreated Chlamydia?

About 10 to 15 percent of women with untreated chlamydia get pelvic inflammatory disease (PID). Permanent damage to fallopian tubes, uterus and surrounding tissues leads to chronic pelvic pain, infertility and the potential for an ectopic pregnancy.

Chlamydia can increase your risk of becoming infected with HIV, if you are exposed to the virus. Complications among men are rare. The infection can spread to the epididymia, which is the tube that carries sperm from the testes. This causes pain, fever and in rare cases, sterility.

How is the Spread of Chlamydia Prevented?

The guaranteed way to protect you against chlamydia is abstinence from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex male condoms, when used correctly and consistently, can reduce the risk of transmission.

The CDC recommends annual testing for all sexually active women, who are 25 years old or younger, for older women who have a new sex partner or multiple sex partners, and all pregnant women. In some cases, more frequent screening may be necessary.

Sources

(1) Centers for Diseases Control and Prevention: Chlamydia: CDC Fact Sheet, Dec. 9, 2011
http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm

(2) PubMed Health: Chlamydia, Dec. 9. 2011
http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm

(3) Health Beat from Illinois Department of Public Health: Chlamydia, Dec. 13, 2011
http://www.idph.state.il.us/public/hb/hbchlam.htm

Reviewed December 19, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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