Lloydspharmacy.com Health

Reviewed by Dr David Delvin, GP and member of the British Association for Sexual Health and HIV

What is chlamydia?

Chlamydia is a sexually transmitted infection (STI) caused by a tiny bacterium, Chlamydia trachomatis.

Chlamydia is the most common STI in the UK. It affects both sexes, although young women are more at risk.

In 2009, 216,000 people were treated at genitourinary medicine (GUM) clinics for chlamydia. Of these, 130,000 were women, and 86,000 were men.

Many more cases were treated by GPs or by private doctors. And it’s thought that tens of thousands of other people have caught the infection, but they are unaware that they’ve got it.

Screening has recently shown that in some parts of Britain, 10 per cent to 20 per cent of young adults have chlamydia.

Chlamydia can be cured, but unfortunately it often produces no symptoms in either men or women, so it can remain undetected.

If left untreated it can have serious complications. It has recently been estimated that 40 per cent of women who have untreated chlamydia may develop pelvic inflammatory disease (PID), a condition in which the internal genital organs are permanently damaged. The results may be sterility and long-term pain.

Are there any symptoms?

Good advice

Get yourself tested if you think you have been at risk of infection.

Some women may experience:

cystitis
change in vaginal discharge
mild lower abdominal pain.

These are very 'non-specific’ symptoms and can be caused by other infections and diseases. If you go to a GP or family planning doctor with these symptoms, make sure you have a chlamydia test. You are entitled to ask for the test if you aren't offered it.

In men, chlamydia often causes of discharge from the penis. Sometimes it can cause mild irritation at the tip of the penis that disappears after two or three days.

Many men will wait to see if the discomfort goes away. While the discomfort may disappear, the man can still harbour the infection.

If in doubt, get tested. Otherwise, you could put yourself at risk of inflamed and swollen testicles, and pass chlamydia on to your partner.

In recent years, it has become clear that chlamydia can quite often affect the eyes. If you develop conjunctivitis in one eye, and it won’t clear up despite treatment from your doctor, you should go to a genitourinary medicine (GUM) clinic for a chlamydia test.

What complications can chlamydia cause?

In some women chlamydia can cause pelvic inflammatory disease (PID). This can damage the Fallopian tubes, which carry eggs from the ovaries to the womb. The tubes may stop working properly and can become completely blocked – causing sterility.
Chlamydia can also cause salpingitis, which is a painful inflammation of the Fallopian tubes.
Chlamydia infection can affect sperm function and male fertility. It's the most common cause of inflammation in the testicles and sperm-conducting tubes (epididymo-orchitis) in men under the age of 35. Symptoms include pain and swelling in the scrotum.
Chlamydia can also trigger joint inflammation in some men. Although this is uncommon, it can be difficult to treat.

Where can you get tested and treated?

The UK's genitourinary medicine (GUM) clinics form one of the best networks in Europe to diagnose and treat STIs. But people often have no reason to think they have chlamydia, so they don't seek advice at one of these clinics.

Regrettably, doctors working in other fields may not suspect chlamydia when assessing a person’s symptoms, so they don't do an appropriate test.

Healthcare professionals are often unaware of how common chlamydia is and that it can be present without causing symptoms.

So in general, if you have taken a risk – it’s best to go to a GUM clinic for assessment.

Good advice

Make sure your friends have heard about chlamydia and its consequences.

Encourage them to get a check-up if they think they are at risk.

How is chlamydia diagnosed?

A chlamydia test is NOT routinely carried out when you have a smear test.

Many women are under the illusion that it is, and are falsely reassured.

If you are unable to get a chlamydia test at your local practice, have a check-up at your nearest GUM clinic.

This is really important if:

you are under 25
you changed sexual partner recently and developed symptoms a few months later
you have had more than two partners in the last year.

At a GUM clinic, tests for women are done by taking swabs from the urinary opening, and from the cervix.

Tests can also be done on a urine sample, or on a swab that the woman can take from her vagina on her own. The sample is then placed into the container provided and sent to a laboratory.

These 'home' tests avoid the need for an intimate, and possibly uncomfortable, examination and make testing much easier for women.

For men, a urine sample is good enough and avoids the discomfort of a swab from the tube inside the tip of the penis (urethra).

The results of the tests usually take around seven to ten days to come through.

Where can I get this help?

Usually, the best place to get help is from the health advisers who work in sexual health (GUM) clinics.

To find your nearest clinic, check the phone book, call NHS Direct (NHS 24 in Scotland) or use the NHS choices website.

How is chlamydia treated?

Chlamydia is treated with antibiotics.

In Britain at the moment, the two most commonly-used ones are azithromycin (eg Zithromax, Clamelle) and doxycycline (eg Vibramycin).

Make sure your sexual partner also gets treatment. Otherwise, the treated partner becomes re-infected.

Also do what you can to encourage any ex-partners to get tested.

How can I make sure I don't get chlamydia?

Use condoms with new sexual partners.
Before you stop using condoms, make sure you and your partner get checked out for STIs by your local GUM clinic.

Based on a text by Dr Angela Robinson, consultant in sexual health

Last updated 03.12.2010