Chlamydia, a sexually transmitted infection (STI), has been on the rise for many years in the U.S. That’s alarming because the bacterial infection can lead to infertility and other long-term health problems in both women and men.
While chlamydia reports dropped during the pandemic, experts say that’s not likely because the spread has slowed. Instead, research suggests the dip is because COVID-19 stopped people from going for routine screening. (Most infections don’t have symptoms, so they’re only picked up during yearly screenings.)
Now, with more people unknowingly infected with chlamydia, and campuses, clubs, and more opening up, experts fear a surge in cases. In fact, chlamydia is the most commonly reported STI in the U.S.
“As a midwife, I understand the importance of screenings and preparing the body for pregnancy,” says Christa Bamburg, CNM, an obstetrics and gynecology specialist at UPMC Hanover and Carlisle. “Reproductive diseases and infertility sometimes can be traced back to an undiagnosed or ignored STI. We want to educate our patients and their partners about how to protect themselves.”
Here’s what you need to know about chlamydia, including treatment and prevention.
How Is Chlamydia Spread?
Chlamydia is a bacterial infection that spreads through sexual contact. It can spread to men and women from vaginal or anal sex, even if a man does not orgasm.
In rare cases, chlamydia can spread from or to the mouth during oral sex. This is far less common because the bacteria doesn’t infect the mouth or throat as easily.
In most cases, people with chlamydia don’t notice any symptoms. This is why yearly screening is important for people who have unprotected sex outside of a long-term monogamous relationship. When symptoms present, they depend on the location of the infection.
Symptoms in women may include:
- Vaginal discharge that is yellowish, smells different, or is otherwise abnormal.
- Pain during urination.
- Burning during urination.
- The urge to urinate more often than normal.
- Painful sex.
- Abdominal or lower back pain.
- A low fever.
- Bleeding between menstrual periods or after sex.
Symptoms in men may include:
- Watery or pus-like discharge from the penis.
- Pain during urination.
- Burning during urination.
- Testicular pain, swelling, or both.
Symptoms of chlamydia in the rectum are the same for both men and women. They include:
- Anal pain.
- An itchy anus.
- Discharge or bleeding from the anus.
While oral chlamydia is much more rare than other forms, it may cause:
- No symptoms.
- A sore, swollen throat.
- Sores in or around the mouth.
- Mouth pain.
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A chlamydia test can be a simple urine test, or a vaginal, rectal, or throat swab. The test type depends on the clinic, as well as your sexual anatomy, sexual history, and symptoms.
Anyone with symptoms of chlamydia and possible exposure should get tested.
In addition, the Centers for Disease Control recommends yearly screening for:
- Women from when they are sexually active until age 25.
- Women older than 25 who have unprotected sex with multiple partners.
- Men who have sex with men (excluding oral sex).
- People who are HIV+ (as HIV infection increases the risk of a chlamydia infection).
If you have chlamydia, your doctor will prescribe antibiotics. You may need to take one dose of antibiotics or take the drugs every day for a week. The type of antibiotic you take may depend on whether you’re pregnant or have allergies.
In rare cases, people with an aggressive type of chlamydia bacteria need treatment for 21 days. (Tests screen for this type of bacteria.)
People should refrain from sex until one week after their first dose. They should also tell any sexual partners from the last 60 days to go for testing. Public health staff can also make these calls without revealing your identity.
Long-Term Problems From Untreated Chlamydia
If left untreated, chlamydia can lead to pelvic inflammatory disease. This is a painful pelvic condition that can lead to scarring of the fallopian tubes and infertility in women.
In rare cases, chlamydia can also cause infertility in men, as well as liver problems and arthritis in both men and women.
Routine screening and treatment can help people avoid long-term complications of chlamydia.
Chlamydia also can pass from an infected mother to her baby during childbirth. Babies born with the infection may suffer from pneumonia, an eye infection, or low birth weight.
“I recommend anyone planning to conceive should screen for STIs along with their partners prior to conception,” Bamburg says.
You can prevent chlamydia in the following ways:
- Abstaining from sex, especially vaginal or anal sex.
- Using condoms at all times during vaginal or anal sex.
- Considering condoms or dental dams to reduce the risk with oral sex, especially with someone who has multiple partners.
- Testing for chlamydia at the beginning of a new relationship.
- Only having unprotected sex within a monogamous relationship (meaning neither person has any other sexual partners while they are together).
When both partners test negative and don’t have any other sexual partners, they’re not at risk of chlamydia.
“It’s important for anyone who is sexually active to have a conversation about STIs and reproductive health with their partner and primary care provider,” Bamburg says. “Talking about their sexual history and current lifestyle choices can help them make critical, informed decisions.”
Centers for Disease Control. Chlamydia – CDC fact sheet (detailed). Link
Centers for Disease Control. Screening recommendations: Chlamydia. Link
Jillian Kramer. Rates of sexually transmitted infections likely rose during the pandemic. National Geographic. Link
Dr. Casey Pinto et al. Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S. American Journal of Preventative Medicine. Link
Planned Parenthood. Chlamydia. Link
World Health Organization. Recommendations for treatment of chlamydia infections. Link
About Infectious Diseases
If you have a disease caused by bacteria, fungi, parasite, or virus, the UPMC Center for Care of Infectious Diseases can help. Our team of experts is specially trained in the prevention and treatment of infectious diseases, including of HIV-AIDs, postsurgical and transplant infections, illnesses caused by international travel, and more. We research infectious diseases and participate in clinical trials to learn more and develop better treatment and prevention methods. Visit our website to find an expert near you.