Chlamydia: Symptoms, Treatment & Prevention

Chlamydia is often called a silent infection because many people have no symptoms. It is a common sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis and may cause painful urination, abnormal vaginal or penile discharge, or pelvic pain.

Chlamydia spreads through unprotected vaginal, anal, or oral sex and can also pass from mother to baby during childbirth. The infection can affect the urethra, cervix, rectum, or throat and may increase the risk of pelvic inflammatory disease (PID), infertility, and other reproductive complications.

Chlamydia is diagnosed with urine tests or swabs and is treated with antibiotics, most commonly doxycycline or azithromycin in certain situations. Prompt chlamydia treatment can cure the infection, reduce the risk of complications, and help prevent transmission to sexual partners.

Chlamydia symptoms

The main symptoms of chlamydia are:

• Pain or burning during urination (dysuria)

• Pus-like vaginal or penile discharge

• Pain or bleeding during sexual intercourse

• Pelvic pain

• Testicular pain and swelling in men

• Bleeding between menstrual periods

Chlamydia symptoms may appear 1 to 3 weeks after unprotected sex, although many people never develop symptoms. However, a person can still spread the bacteria even when there are no noticeable signs or symptoms.

If chlamydia in women is not diagnosed, the bacteria may spread through the reproductive organs and cause pelvic inflammatory disease (PID). PID is a leading cause of infertility, chronic pelvic pain, and ectopic pregnancy.

In men, untreated chlamydia may cause epididymitis, an inflammation of the tube that carries sperm from the testicle. In some cases, the infection may also involve the testicle (epididymo-orchitis) and affect fertility.

Chlamydia treatment

Chlamydia treatment should be prescribed by a primary care provider, gynecologist, urologist, or another healthcare professional. It usually involves doxycycline, the preferred first-line antibiotic, or azithromycin when doxycycline is not appropriate, such as during pregnancy or when completing a 7-day course is unlikely.

The full course of antibiotics should be completed even if symptoms improve or disappear. Proper treatment can cure chlamydia, but complications that have already developed, such as pelvic inflammatory disease or infertility, may be permanent.

According to the CDC, sexual partners should also be evaluated and treated to help prevent reinfection. Sexual activity should be avoided until treatment is complete and all sexual partners have been treated.

Confirming a diagnosis

Chlamydia is diagnosed by a healthcare provider based on symptoms, medical and sexual history, and laboratory testing. Because many people do not have symptoms, screening is also recommended for certain people at higher risk.

To confirm the diagnosis, the healthcare provider may order a urine test or collect a swab from the vagina, cervix, rectum, or throat, depending on symptoms and the type of sexual exposure. These tests detect the presence of Chlamydia trachomatis.

How do you know if you have chlamydia?

According to the CDC, chlamydia screening is recommended because the infection often causes no symptoms.

Annual screening is recommended for all sexually active women younger than 25 and for women 25 and older who have an increased risk of infection, while screening for men is recommended for certain higher-risk groups and clinical settings.

How do you get chlamydia?

Chlamydia is an infectious disease caused by the bacterium Chlamydia trachomatis. It can spread through oral, vaginal, or anal sex without a condom.

People who have multiple sexual partners have a higher risk of becoming infected.

Chlamydia can also pass from mother to baby during childbirth if the pregnant person has the infection and has not received appropriate treatment.

When is it safe to have sex again?

Sexual activity should only be resumed after treatment has been completed and all sexual partners have been treated.

If antibiotics were prescribed for 7 days, sexual activity can be resumed after the full course has been completed, as long as symptoms have resolved.

If a single-dose antibiotic was prescribed, sexual activity can be resumed 7 days after taking the medication, as long as symptoms have resolved.

Can chlamydia be cured?

Chlamydia can usually be cured with antibiotics. If a 7-day course of antibiotics is prescribed, treatment should be completed before resuming sexual activity.

If a single-dose antibiotic is prescribed, sexual activity should be avoided for 7 days after taking the medication. Sexual partners should also be treated before sex is resumed to help prevent reinfection.

People living with HIV can be treated in the same way as people who do not have HIV. A different antibiotic regimen or hospitalization is generally not necessary.

How to prevent

To help prevent chlamydia, condoms should be used correctly during vaginal, anal, and oral sex. Limiting the number of sexual partners may also reduce the risk of infection.

During chlamydia treatment, sexual activity should be avoided for 7 days after a single-dose antibiotic or until a 7-day treatment course is completed and any symptoms have resolved. Sexual activity should not resume until all sexual partners have also been treated to help prevent transmission and reinfection.

According to the CDC, pregnant women younger than 25 and those at increased risk of chlamydia should be tested at the first prenatal visit and again during the third trimester. Prompt treatment can reduce the risk of passing chlamydia to the baby during childbirth.

Possible complications

Chlamydia may cause complications such as:

• Pelvic inflammatory disease (PID)

• Ectopic pregnancy

• Chronic pelvic pain

• Infertility

These complications may develop when chlamydia is not treated properly. For this reason, it is important to see a healthcare provider as soon as symptoms appear so that treatment can begin promptly.

Risks of chlamydia during pregnancy

Chlamydia during pregnancy may increase the risk of preterm birth and low birth weight. Untreated infection can also be passed to the baby during childbirth.

Because the infection can pass to the baby during vaginal delivery, screening during prenatal care is important. Pregnant people who test positive should follow the treatment prescribed by their healthcare provider.

Babies exposed to chlamydia during childbirth may develop chlamydial conjunctivitis or pneumonia. These infections can usually be treated successfully with antibiotics prescribed by a pediatrician.