Also see entry for Sexually Transmitted Infections
What It Is
Chlamydia is a common sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis, which can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur. Chlamydia may also cause fertility problems in men.
Who Gets It
Any sexually active person can be infected with chalmydia. The greater the number of sex partners, the greater the risk of infection. Teenage girls and young women are particularly at risk because the cervix is not fully mature yet and is more susceptible to infection.
Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. In 2006, nearly 1,031,000 chlamydial infections were reported in the U.S. Under-reporting is substantial (the true number is closer to 2,291,000 people) because most people with chlamydia are not aware of their infections and do not seek testing. Women are frequently re-infected if their sex partners are not treated. Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.
Chlamydia is known as a silent disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within one to three weeks after exposure.
In women, the bacteria initially infect the cervix and the urethra. Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes, some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. A chlamydial infection of the cervix can spread to the rectum.Men with symptoms might have a discharge from their penis or a burning sensation when urinating, or burning and itching around the opening of the penis.
How It's Diagnosed/Detected
To help prevent the serious consequences of chlamydia, it’s recommended that all sexually active women age 25 and younger be screened annually. An annual screening is also recommended for older women with risk factors for chlamydia (such as a new sex partner or multiple sex partners). All pregnant women should have a screening test for chlamydia. The screening generally consists of a cervical swab, which is then examined for the presence of the bacteria.
How It Affects Fertility (And Pregnancy)
In women, an untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID), which occurs in up to 40 percent of women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, and an ectopic pregnancy. Having multiple infections increases a woman's risk of serious reproductive health complications, including infertility. Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed. Complications among men are rare. The infection sometimes spreads to the epididymis (the tube that carries sperm from the testes), causing pain, fever, and (rarely) sterility.
Chlamydia can be easily treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline are the most commonly used treatments. All sex partners should be evaluated, tested, and treated. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible. Women whose sex partners have not been appropriately treated are at high risk for re-infection.
Women whose Chlamydia is promptly treated should not have problems. But multiple infections or infections left untreated may cause difficulties. Some studies indicate that active chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns.
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