What is chlamydia?
Chlamydia is the most common sexually transmitted infection (STI) in the UK, accounting for nearly half of all STI diagnoses
(PHE 2017b). It affects both men and women, causing an infection in the urethra (the tube that carries urine out of the body). Less commonly, it can also cause an infection in the anus (rectum), the back of the throat or the eyes
(NICE 2016).
Chlamydia can be easily treated with antibiotics. But if you leave it untreated, it can have serious consequences for your sexual health and fertility
(Harding 2016).
What are the symptoms of chlamydia?
Most people who get chlamydia don't have any symptoms at all. Seven in 10 women and five in 10 men who have it show no signs of infection
(NICE 2016). A lot of people only find out they have it when they have a test for chlamydia or other STIs
(Harding 2016).
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Even if you do have symptoms, these can easily be confused with other, less serious conditions such as
thrush (NICE 2016, NHS 2017).
If you do develop symptoms, they may show up any time from a week after coming into contact with the infection, to months later
(FPA 2016).
In women, symptoms of chlamydia can include:
- pain or discomfort when weeing
- increased vaginal discharge, or discharge containing pus
- pain in your lower abdomen
- bleeding between periods or after sex
- pain during sex
(Harding 2016, NICE 2016)
In men, symptoms of chlamydia can include:
- cloudy discharge from the tip of the penis
- pain or discomfort when weeing
- swollen and painful testicles
(Harding 2016, NICE 2016)
In both men and women, an infection in the throat is unlikely to cause any symptoms. You’re also unlikely to experience any symptoms if the infection affects your eyes or your anus, although there may be some discomfort and discharge
(FPA 2016).
What complications can chlamydia cause?
If you don't get treatment for chlamydia, it can spread further into your reproductive organs and cause more serious, long-term complications. These can include
pelvic inflammatory disease (PID) and
fertility problems caused by damage to your fallopian tubes
(Harding 2016, NICE 2016).
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A few small studies have suggested that chlamydia may also reduce fertility in men, however we need more research to be sure
(FPA 2016, Harding 2016).
Some people with chlamydia can go on to develop a condition called reactive arthritis (Reiter's syndrome)
(Harding 2016). If you have this, you may get inflamed and sore eyes (conjunctivitis) and painful joints (a form of arthritis), together with your other symptoms
(Harding 2016). It's more common for men to get it - around one in 100 men with chlamydia may develop reactive arthritis - although women can get it too
(SIGN 2009).
The infection can be passed from mother to baby during
birth, causing eye infection or, in rare cases, pneumonia in the baby
(NICE 2016, RCGP 2013). If your baby develops either of these infections, he will be treated with oral antibiotics
(Nwokolo et al 2016).
Untreated chlamydia can also cause complications in pregnancy. The infection is thought to be linked to
premature labour and having a baby with a
low birth weight (NHS 2015, NICE 2016, RCGP 2013). Sadly, it can also cause
miscarriage (NHS 2015, NICE 2016, RCGP 2013).
How is chlamydia spread?
Chlamydia is usually spread by having sex or sharing sex toys, so anyone who has sex without a condom can catch it
(FPA 2016, NICE 2016). This includes anal or oral sex, and any genital contact with an infected person
(FPA 2016). It can also be passed from mother to baby during childbirth
(FPA 2016, NICE 2016). If the semen or vaginal fluid of an infected person comes into contact with your eyes, you could develop conjunctivitis
(FPA 2016, NICE 2016).
You can't catch chlamydia from kissing and hugging, from contact with toilet seats or swimming pools, or from sharing towels, cups, plates and cutlery
(FPA 2016).
How is chlamydia diagnosed?
Tests for chlamydia are very straightforward. For women, the usual test is a vaginal swab, which is completely painless. Or you may sometimes be asked to have a urine test.
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For men, the test is usually a urine test
(Harding 2016, NICE 2016), or you may be offered a urethral swab, where the doctor or nurse takes a swab around the entrance of your urethra (where your urine comes out)
(Harding 2016, NICE 2016).
If you've had anal or oral sex, your doctor or nurse will offer to take a swab from your back passage or your throat
(FPA 2016).
The sample will then be sent to a lab for analysis to find out if you have chlamydia
(Harding 2016, NICE 2016).
Who should get tested for chlamydia?
If you’ve ever had sex without a condom, it’s worth getting tested
(FPA 2016), particularly if you’re planning a pregnancy, now or in the future.
Most people who have chlamydia have no symptoms
(NICE 2016), which means it’s easily spread. Two thirds of people who have sex with someone with chlamydia will catch it
(RCGP 2013). And there’s no way to tell for sure if the person you’re sleeping with already has chlamydia. So it’s best to get checked, just to be on the safe side.
It’s particularly important to get tested if you’re in an at-risk group. Chlamydia is most common in young people aged between 15 and 24. In this age group, about one in 11 people who get themselves tested are infected
(PHE 2017b).
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You should also consider getting tested if:
- you or your partner think you might have symptoms
- your partner has been told they have chlamydia
- you've had unprotected sex with a new partner
- you or your partner have had unprotected sex with other partners
- you've had a vaginal examination, and the nurse or doctor says the cells of your cervix are inflamed
- you have another sexually transmitted infection
(FPA 2016)
In England, there is a national chlamydia screening programme (NCSP), aimed at trying to reduce the spread of the infection and raise awareness. Screening is targeted at men and women under 25
(PHE 2017b), who account for up to 70 per cent of reported cases
(NICE 2016). If you're in this age group, your doctor may recommend you get tested once a year, or sooner if you've got a new partner
(NICE 2016).
You should also be tested for chlamydia before undergoing certain tests for infertility and fertility procedures. This is because investigations in your womb and fallopian tubes could reactivate an infection and cause more problems
(NICE 2017).
If you’ve been treated for chlamydia in the past, you can still get reinfected if you come into contact with it again
(NICE 2016). So it’s always a good idea to get tested after having sex with a new partner
(FPA 2016).
Where can I get tested for chlamydia?
There are a number of places you can get tested. The most obvious is to visit your local GP or sexual health clinic to arrange for a free test for chlamydia on the NHS
(FPA 2016).
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If you don’t want to go to your GP, you may prefer to visit a sexual health clinic. They can also offer tests for other STIs which don’t have symptoms, such as
HIV. And if you do have chlamydia or another STI, they can offer counselling, and help you get in touch with your previous sexual partners. These clinics are confidential and will not inform your GP of the results of your tests unless you ask them to
(FPA 2016, NICE 2016).
You don't need to be referred by your
GP to attend a sexual health clinic. There may be a waiting list for an appointment, or the clinic may run a walk-in system, where you wait your turn.
(FPA nd).
The clinic or your GP may offer a urine test or vaginal swab, or provide you with a kit to do this yourself in the comfort of your own home, before sending it off to a lab for analysis
(NICE 2016, RCGP 2013). They may also offer you tests for other STIs at the same time
(Harding 2016).
If you're aged between 16 and 24, your local pharmacy, college, nightclub or community youth centre may offer screening tests. Tests are also offered to women at some abortion clinics, or through antenatal or gynaecology services
(FPA 2016).
You can also order chlamydia tests online, to do yourself at home. In some areas of the country, you may be able to get a testing kit for free
(Harding 2016). Search online or ask your GP what services are available near you.
If you're not eligible for a free test, they usually cost around £20-£30 to buy online. The test may cost more if it checks for other diseases too. If your result is positive, you can contact your GP to get treatment. Alternatively, you can send off for treatment from a registered private provider, following the test instructions.
How is chlamydia treated?
Chlamydia infections are treatable with antibiotics. Your GP will prescribe either a seven-day course of doxycycline or a one-off dose of azithromycin
(Harding 2016, NICE 2016). If these antibiotics aren’t suitable for you (for example if you’re allergic to them), your doctor will offer you a different antibiotic, which you may need to take for up to two weeks
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If you're treated early enough, you're unlikely to get any complications. In the majority of cases (about 95 per cent), antibiotics are enough to get rid of the infection
(Harding 2016).
It's important that your sexual partner is treated too. If not, there's a risk that you'll become reinfected
(Harding 2016). It's also important that any other recent sexual partners are notified, to let them know they should go for a check-up. A sexual health clinic can contact them for you if you prefer
(FPA 2016).
Don’t have sex (including oral and anal sex) until you and your partner have completed the course of treatment, to prevent reinfection
(NICE 2016). Even if you use a condom, you could still spread the infection, so it's best to avoid sex altogether for a short while
(Harding 2016, NHS 2015).
If you’re treated for chlamydia during pregnancy, you’ll be offered another test about three weeks after treatment to make sure the infection has gone
(Harding 2016, NICE 2016). Although it's unlikely, there's still a small possibility of passing the infection onto your baby when he’s born, after you've been treated
(SIGN 2009).
If your baby develops symptoms such as an eye infection, it's important to get it checked out
(Nwokolo et al 2016, SIGN 2009). He’ll need a course of antibiotics to get better
(NHS 2015) Advertisement | page continues below
Remember that chlamydia is very common, the test is painless, and it’s easily treated
(NHS 2015). If you have any doubts or concerns, it’s always best to get tested to put your mind at rest.
