How Serious Is Chlamydia?

What Is Chlamydia?

Chlamydia is the most common sexually transmitted infection (STI) in the U.S., with about four million cases each year. It can affect both men and women.

What Are Symptoms of Chlamydia?

Most people infected with chlamydia have no symptoms, which can make it easy to spread the infection. When symptoms do occur, they can range from mild to serious. 

Up to 70 percent of men with chlamydia have no symptoms. When symptoms do occur in men, they may include:

  • Discharge from the penis
  • Burning or pain with urination
  • Testicular pain or tenderness 
  • Swelling in the scrotum 

Up to 90 percent of women with chlamydia have no symptoms. When symptoms do occur in women, they may include:

Men and women who have anal sex with infected men can develop chlamydia infection in the rectum or anus.

Chlamydia may also cause an inflammation of the conjunctiva (conjunctivitis) if a person is exposed to semen or vaginal discharge from an infected person.

In rare cases, people with chlamydia can develop reactive arthritis which can cause seemingly unrelated symptoms, including: 

What Causes Chlamydia?

Chlamydia is caused by infection by the bacterium, Chlamydia trachomatis. The infection is spread during intimate sexual contact. A man does not have to ejaculate to spread the infection.

Risk factors that increase the chance of getting chlamydia include: 

  • A new sexual partner
  • Having more than one sexual partner
  • Having a previous chlamydia infection and having sex with a partner who has not been treated for the infection

How Is Chlamydia Diagnosed?

Chlamydia is diagnosed with a urine sample or with a swab of fluid from the vagina or cervix (in women), from the urethra (in men), or from the rectum in women and men. 

Results are usually available within 24 hours.

What Is the Treatment for Chlamydia?

Chlamydia is treated with antibiotics. The recommended treatment is 1 g azithromycin taken orally in a single dose. Azithromycin is safe for use during pregnancy

Other antibiotics may be used if patients are unable to take azithromycin, such as:

  • Doxycycline 100 mg orally twice a day for 7 days
  • Erythromycin base 500 mg orally four times a day for 7 days
  • Erythromycin ethylsuccinate 800 mg orally four times a day for 7 days
  • Levofloxacin 500 mg orally once daily for 7 days
  • Ofloxacin 300 mg orally twice a day for 7 days

Patients are advised to avoid sex for seven days after completing the antibiotic treatment.

Sexual partners should also be treated. All sexual partners of the patient in the last 60 days should be tested for chlamydia, even if they do not have symptoms. It is possible to be re-infected with chlamydia, and the most common reason this occurs is when sexual partners are not treated.  

After treatment, patients should be re-tested for chlamydia about three months after their diagnosis because many people are re-infected from untreated sexual partners.

What Are Complications of Chlamydia?

Untreated chlamydia can cause serious complications. 

Complications of chlamydia in women include: 

Complications of chlamydia in men include: 

  • Inflammation of the testicles and epididymis (tubes that carry sperm from the testicles) (epididymitis or epididymo-orchitis)
  • Sexually acquired reactive arthritis (SARA)
    • SARA can also affect women who have had chlamydia but it is more common in men

How Do You Prevent Chlamydia?

Chlamydia may be prevented by:

  • Avoiding sexual intercourse (this is the best way to prevent infection, but also the least practical for many people)
  • Use condoms every time you have sex
  • Tell your doctor about any sexually transmitted infections and receive an annual chlamydia screening
  • See your healthcare provider if you have any symptoms of chlamydia or another infection
  • Do not have sex if you or your sexual partner has any symptoms of chlamydia such as abnormal discharge, burning with urination, or a genital rash or sore