What are the Symptoms of Chlamydia?
Chlamydia is really very common and most people have no symptoms.
When Symptoms do occur, they may include:
- Males: Pain on passing urine or discharge (yellow or white). Pain and swelling in the testicle or scrotum (orchitis / epididymitis).
- Females: Stinging on passing urine, discharge (yellow or white), abnormal vaginal bleeding, pelvic or lower abdominal pain, fever, pain during intercourse.
Infection may also occur in the throat, causing pharyngitis, or conjunctiva, causing conjunctivitis.
Why does Chlamydia matter when most people have no symptoms?
The main concern with chlamydia is infertility in women. How common is infertility after having chlamydia?
Around 15% of women with Chlamydia will develop pelvic inflammatory disease (PID). This occurs when the infection travels up to the fallopian tubes and typically causes abdominal and pelvic pain. The chances of developing infertility after PID caused by chlamydia is between 1% and 20% (frustratingly different figures hey?). PID may also lead to chronic pelvic pain, and there is an increased risk of pregnancy in the tube (ectopic pregnancy).
So there’s no need to panic because the chances of becoming infertile are still low. But on a population level, there are lots of women who have “tubal infertility” caused by chlamydia.
Chlamydia may also cause infection of the testicle or prostate in men.
What is The treatment for Chlamydia?
Chlamydia is so easy to treat with 2 x 500mg tablets of Azithromycin taken as a single dose. Side effects are uncommon but some people experience gastro type side effects such as nausea, vomiting, diarrhoea or abdominal pain. An alternative to Azithromycin is a 7 day course of doxycyline which is taken twice daily with food. Doxycycline may cause similar gastro side effects to Azithromycin. Doxycycline may cause sensitivity to the sunlight during the course, and it is recommended to try to stay out of the sun. A small print issue is that rectal chlamydia may be more resistant to azithromycin than doxycyline.
Do I need a test of cure?
Test of cure involves repeat testing at least 3 weeks after treatment. Antibiotics work around 97% to 98% of the time but are not 100% effective so it is reasonable to have a discussion about test of cure. In the publicly funded UK national health service, test of cure is “not routinely recommended for uncomplicated genital chlamydia infection.”