Chlamydia

Chlamydia ia one of the most common sexually transmitted infections (STIs). If untreated it can become painful and cause serious health problems such as infertility. This leaflet gives you information about Chlamydia, advice on how to protect yourself and how to get treated if you think that you might have the infection.

What causes Chlamydia?

Chlamydia is caused by bacteria, which are found in semen and vaginal fluid and are easily passed from one person to another through sexual contact. It is particularly common in younger people but anyone who is sexually active can get it. Both men and women can have, and pass on Chlamydia. Often there are no symptoms or they may be so mild you do not know you have it.

How is Chlamydia passed on?

Chlamydia can be passed from one person to another during sex. The bacteria can live inside the cells of the cervix (entrance to the womb), the urethra (the tube where urine comes out), the rectum (back passage) and sometimes the throat and eyes.
The infection can spread if you have vaginal, anal or oral sex or share sex toys. Using a condom correctly will reduce your chance of getting or passing on Chlamydia.
It is also possible to transfer the infection from the genital area to the eyes and for a pregnant woman to pass the infection to her baby.
It is not fully understood at the moment how possible or easy it is to spread the infection by transferring semen or vaginal fluid to another person’s genitals on the fingers or through rubbing vulvas together.
You cannot catch Chlamydia from kissing, hugging, sharing baths or towels, from swimming pools, toilet seats or from sharing cups, plates or cutlery.

How can I protect myself from Chlamydia?

· Use condoms (male or female) every time you have anal or vaginal sex.
· If you are not sure how to use condoms correctly call fpa (see links)
· If you are not happy with the condoms you are using now, why no try a different brand or type? They come in a variety of shapes and sizes.
· Avoid sharing sex toys – if they are shared wash them or cover them with a new condom before anyone else uses them.
· For oral sex, cover the penis with a condom or the female genitals with a latex square (dental dam).

These measures can also protect you from some other STI’s such as HIV and gonorrhoea. If you have Chlamydia without knowing it they will also help prevent passing it on.

What are the Symptoms?

At least half of all infected men and women will not have any symptoms at all. If you think you could have Chlamydia then go for a check-up and encourage your partner to be checked for infection. GPs and clinics don’t mind doing check-ups.
Symptoms can show up 1-3 weeks after coming into contact with Chlamydia, many months later or not until the infection spreads to other parts of your body. If you do get symptoms you might notice:

Women
· An unusual vaginal discharge
· Pain when passing urine
· Bleeding between periods (including women who are using hormonal contraception)
· Bleeding after sex
· Pain and /or bleeding when you have sex
· Lower abdominal pain

Men
· A white/ cloudy and watery discharge from the tip of the penis
· Pain when passing urine
· Painful swelling of the testicles

Infection in the rectum rarely has symptoms but may cause discomfort, and discharge in both men and women. If the eyes become infected you may experience pain, swelling, irritation and discharge (conjunctivitis). Infection in the throat usually has no symptoms.

If I don’t get symptoms how will I know if I have the infection?

You won’t know unless you have a Chlamydia test. If you or your partner think you might have symptoms of an infection, you should both have a test. Even if you don’t have symptoms you may wish to be tested particularly if:
· You have had unprotected sex with a new partner recently
· You or your partner has had unprotected sex with other parners
· During a vaginal examination your doctor or nurse says that the cells of the cervix are inflamed or there is a discharge
· A sexual partner tell you they have an STI
· You are found to have another STI

How soon after sex can I have a test?

Chlamydia can show up on the test a few days after you have been in contact with it, often before you have symptoms, however for absolute certainty a test 2 weeks after the risk is best.
You can go to a genitourinary medicine (GUM) clinic, a sexual health clinic or to your GP. If your GP doesn’t offer testing they will refer you to a clinic that does. Don’t delay seeking advice – clinics don’t mind doing “check-ups”. Tests are also available at some family planning clinics and young people’s services, call first to check.
It is not uncommon to have more than one infection so ask about being tested for others. A leaflet Sexually transmitted infections – where to go for help and advice is available free from fpa (see links page).

What does the test involve?

Female patients can do a self taken low vaginal swab. Men can do a first catch urine test. If there are symptoms or a discharge then a doctor or nurse will use a swab to collect a sample of cells.
There are many myths about how swabs are done. A swab looks a bit like a cotton bud, but it is smaller and rounded. The swab is wiped over parts of the body that could be infected and easily picks up samples of discharge and cells. It only takes a few seconds and is not usually painful, though it may uncomfortable for a moment.
Swabs may be used to pick up cells from:
· The cervix during an internal examination (in women)
· The urethra (tube where the urine comes out)
· The rectum (back passage)
· The throat
· The eye
No tests are 100% accurate, but Chlamydia tests should pick up almost all infections. Cervical smear tests and routine blood tests do not detect infections such as Chlamydia. If you are not sure whether you have been tested for Chlamydia, just ask.

What is the treatment for Chlamydia?

Early treatment of Chlamydia is simple and involves taking a course of antibiotic tablets. There are several antibiotics that can be used. These are taken as either a single dose or a longer course of one week. If complications have occurred other treatment may also be needed. If there is a high chance of you having the infection, treatment may be started before the results of the test are back. At the moment there aren’t any treatments that you can buy without prescription and there currently isn’t any evidence that complementary therapies can cure Chlamydia.
Some of the antibiotics that are used to treat Chlamydia interact with the combined oral contraceptive pill. If you are taking the pill tell the doctor or nurse and they can advise you what to do. You should also tell the doctor or nurse if you are, or think you might be, pregnant or if you are breastfeeding. This will influence the type of antibiotic given to you.

How effective is the treatment?

Treatment is very effective. If you take all the antibiotics according to the instructions it is rare for them not to work. Avoid vaginal, anal and oral sex until you and your partner have both finished treatment, otherwise you could be re-infected. If this is not possible, make sure that you use a condom.

What happens if Chlamydia isn’t treated?

Without proper treatment the infection can spread to other parts of the body causing damage and serious long-term complications.
In women Chlamydia can spread to other reproductive organs causing pelvic inflammatory disease (PID). This can lead to long-term pelvic pain, blocked fallopian tubes, infertility and ectopic pregnancy (pregnancy that occurs outside of the womb). Chlamydia can spread to the liver causing pain and inflammation, though this is rare.
In men it can lead to a painful infection in the testicles and possibly reduce fertility. It is thought that in some men it might cause the prostate to become inflamed. Inflammation of the joints can occur (reactive arthritis) which is sometimes accompanied by inflammation of the urethra and the eye when it is known as Reiter’s syndrome. This is rare and occurs more in men than women.

Can Chlamydia go away without treatment?

It is very unlikely. If you delay seeking treatment you risk the infection causing long-term damage and you may pass the infection on to someone else.

How will I know if Chlamydia has affected my fertility?

Chlamydia is just one of many factors that can affect your fertility. If you have had Chlamydia you will not normally be offered any routine tests to see if you are fertile unless you or your partner find that you have difficulty in getting pregnant. If you are concerned, talk to your GP or practice nurse.

Does Chlamydia cause cervical cancer?

This is a common call to fps’s helplines, but there is currently no evidence that Chlamydia causes cervical cancer.

What happens if I get Chlamydia when I’m pregnant?

Chlamydia may be linked to early miscarriage or premature birth of the baby. It can be passed to the baby during the birth and (less common) before the baby is born. This can cause inflammation and discharge of the baby’s eye (conjunctivitis) and pneumonia. Chlamydia can be treated with antibiotics when you are pregnant and when you are breastfeeding – they won’t harm the baby, but do tell the doctor or nurse that you are pregnant.

How will I know how long I’ve had the infection?

It can be difficult to know, particularly if you don’t get any symptoms or they appear a long time after you have been exposed to Chlamydia. You might not know whether you got Chlamydia from your current or previous sexual partner. These doubts can be hard to handle. Some people feel upset or angry when they have an STI and find it difficult to talk to their partner or friends. Don’t be afraid to talk about how you feel with the staff at the clinic or surgery.

Should I tell my partner?

If you have Chlamydia then it is very important that your current sexual partner and any other recent partners are also tested and treated. The staff at the clinic or doctor’s surgery can discuss with you how you might tell your partner(s). If you feel that this will be too difficult, GUM clinics and some sexual health clinics can give you a ‘contact slip’ to send to your partner(s) or, with your permission, the clinic can do this for you. The slip explains to the person that they may have been exposed to an STI and suggests that they go for a check-up. It does not say what the infection is, or have your name on it, so your confidentiality is protected. This is called partner notification. It’s strongly advised you do tell your partner(s) but it is not compulsory.

Do I need a follow-up?

You may need to go back to check that the infection has gone and that you have not come into contact with the infection again. If you have any questions, ask the doctor or nurse and make sure you know how to protect yourself in the future.