What is Chlamydia?
Chlamydia is one of the most common bacterial sexually transmitted infections worldwide. It is caused by a bacterium called Chlamydia trachomatis. According to the US Centres for Diseases Control (CDC), Chlamydia is the most frequently reported bacterial STD in the US, with 2.86 million infections reported every year.
Who is at risk of getting Chlamydia?
Chlamydia can affect anyone who is sexually active, both males and females alike, regardless of sexual preference or orientation.
Young people may be at higher risk for various reasons, including practices like inconsistent condom usage. Young women may have a benign condition called cervical ectopy, which makes them more susceptible to getting Chlamydia.
How is Chlamydia transmitted?
Chlamydia is transmitted through sexual contact with the genitalia, anal canal or oral cavity of an infected individual – this includes through vaginal sexual intercourse, anal sexual intercourse and oral intercourse. Sexual activities involving the sharing of sex toys and contact with body fluids can also spread Chlamydia.
During childbirth, an infected mother can also transmit Chlamydia to her unborn infant, resulting in complications which are detailed below.
What are the symptoms of Chlamydia?
Most individuals with Chlamydia DO NOT HAVE ANY SYMPTOMS. Less than 50% of both men and women with Chlamydia develop symptoms. This is also why Chlamydia is such a common bacterial STD – because asymptomatic individuals are unaware that they are infected and continue to spread it to their sexual partners.
IF symptoms do develop, they may occur anytime from days to weeks after initial infection.
Chlamydia in males can result in urethritis (inflammation of the urine tract) and epididymoorchitis (inflammation of the testicles or epididymis).
Symptoms of Chlamydia in men include:
- Dysuria (painful urination)
- Urgency and frequency of urination
- Discomfort along the urethra/urine tract
- Penile discharge which is usually clear or watery
- Pain or swelling of the testicles may occur in a less common but serious infection called epididymoorchitis
- Pain or discomfort in the pelvis due to prostatitis (inflammation of the prostate gland)
Chlamydia in females can result in vaginitis, cervicitis and pelvic inflammatory disease (involving the uterus and fallopian tubes).
Symptoms of Chlamydia in women include:
- Abnormal vaginal discharge which may be different in colour, odour, quantity and consistency
- Bleeding after intercourse (post coital bleeding)
- Abnormal spotting/bleeding in between menstrual periods
- Painful intercourse (dyspareunia)
- Abdominal pain or fever can possibly occur during pelvic inflammatory disease (PID), where the infection spreads upwards to affect the uterus and Fallopian tubes, but the bulk of Chlamydia related PID is actually ASYMPTOMATIC
Symptoms of Chlamydia infection not specific to males or females:
- Chlamydia conjunctivitis – red, irritated eyes can occur after contact with infected fluids
- Proctitis (inflammation of the rectum) – can give rise to rectal discomfort, discharge or pain, but most cases of rectal Chlamydia are again ASYMPTOMATIC
- Throat chlamydia tends to be asymptomatic
What are the possible complications of a Chlamydia infection?
In untreated women, Chlamydia can lead to pelvic inflammatory disease, where the infection spreads to the uterus and fallopian tubes, resulting in chronic inflammation, scarring, potential infertility, increased risk of ectopic pregnancies (pregnancies outside of the uterus) and possible chronic pelvic pain. Unfortunately, Chlamydia tends to cause “silent” PID without any symptoms at all.
In men, uncommon but more serious infections affecting the testicles and epididymis can occur.
Chlamydia infection increases the risk of pre-term delivery in pregnant women. Transmission of Chlamydia to the infant during childbirth can also result in severe eye infections (known as opthalmia neonatorum), or lung infections (pneumonia).
A condition called “reactive arthritis” (joint pain and swelling) can occur in both males and females.
Chlamydial infections in both males and females increases the risk of acquiring HIV.
How is a Chlamydia infection diagnosed?
The diagnosis of Chlamydia is best done using nucleic acid amplification testing (NAAT), which detects the presence of Chlamydia trachomatis DNA in a sample:
- In men: a urine sample
- In women: an endocervical swab
- A throat swab or rectal swab can be used to diagnose throat or rectal Chlamydia respectively
How is Chlamydia treated?
Chlamydia is treated with antibiotics, however, there is an increasing concern of resistance to certain antibiotics in various parts of the world.
Testing and treatment of sexual partners is also crucial and infected individuals should abstain from sexual intercourse or activity during treatment. After completion of treatment, a repeat test should also be done to confirm that the Chlamydia infection has truly been cleared.
Your doctor will be able to advise you on the specifics of treatment.
How do I minimise my risk of getting Chlamydia?
You can reduce your risk of Chlamydia through observing safe sexual practices – including consistent and correct use of barrier protection (condoms), reducing the number of sexual partners or being in a mutually monogamous relationship where you know your partner’s infection status.
Regular sexual health screening is also important, since most Chlamydia infections are asymptomatic. In fact, the US CDC recommends yearly Chlamydia screening for sexually active women under the age of 25.
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