Chlamydia

Chlamydia trachomatis (CT) is the commonest STD that can infect both men and women.

The incidence is 2-3 times that of gonorrhoea. You can get CT by having anal, vaginal or oral sex with someone who has Chlamydia. Occasionally, you can also get CT infection in your eyes (conjunctivitis) from spread by the fingers from the genitals to the eye. Also, if you are pregnant, you can pass on Chlamydia to your baby during childbirth which could cause eye infection or lung infection in your newborn.

Risk factors:

Multiple sex partners or a new sexual partner

Younger age group (age 15-24 years)

Unprotected sex

History of previous sexually transmitted disease (STD) or current co-infection with another STD.

Symptoms:

Most individuals with Chlamydia have no symptoms, with up to 50% of infected males and 80% of infected females remaining asymptomatic. As a result, diagnosis is usually delayed. Even when Chlamydia causes no symptoms, it can still damage your reproductive system.

If you do have symptoms, they may appear several days to weeks after having sex with an infected partner.

In women:

–          Abnormal vaginal discharge

–          Abnormal vaginal bleeding (after sex or in between menses)

–          Pain or burning sensation when urinating

–          Pain during sex

–          Lower abdominal pain

–          Fever (can get this due to PID)

In men:

–          Penile discharge (usually yellow thick discharge from the urethra)

–          Pain or burning sensation when urinating

–          Itch or discomfort around the penis

–          Pain and swelling in one or both testicles (less common)

–          Fever

In men or women who practice anal sex, symptoms can include:

–          Rectal pain

–          Rectal discharge

–          Rectal bleeding

Treatment:

Chlamydia can be easily cured with the right antibiotics. Sexual partners also should be tested and treated.

After treatment of Chlamydia it is recommended to get tested again to avoid treatment failures (rare), relapse or re-infection. Re-infection is very common and is usually related to non-compliant of medications, non-treatment of infected sexual partners or acquisition from a new partner; hence it is important that all sexual partners should be tested and treated.

You should refrain from having sex until both you and your sex partner have completed treatment or as advised by your doctor.

The use of latex condoms can help minimize the chances of re-infection.

Complications:

In women, untreated Chlamydia can spread to your uterus and fallopian tubes causing pelvic inflammatory disease (PID). Often, PID is asymptomatic; however some women may experience fever, abdominal or pelvic pain.

Even if PID does not cause any symptoms in the early stages, PID can cause permanent damage to your reproductive system which can lead to long term pelvic pain, subfertility, and increases the risk of ectopic pregnancy (pregnancy outside the uterus).

In men, Chlamydia can cause epididymitis (infection in the tube that carries sperm from the testicles) causing pain and fever. Rarely, it causes infertility in men.

Also, untreated Chlamydia may increase your chances of getting other STDs, especially gonorrhoea.

Patients with Chlamydia also have a higher frequency of getting Reiter syndrome (inflammation of the urethra, eyes (conjunctivitis) and joints).

Untreated chlamydia is also linked with an increased risk of cervical cancer and also HIV infection.

If you think you are at risk of contracting chlamydia, it would be advisable to get tested as it is an easy and quick test (in men – urine test, in women – vaginal swab test) and chlamydia is easily treated.

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30 Comments

  1. Hi Doc,

    After treatment of Chlamydia or Gonorrhea (I dunno the results yet) and the symptoms go away after a few days, is it recommended after 7 days, when I go back to retest for Chlamydia/Gonorrhea (test of cure), is the test result accurate? After how much time do I conclusively know I am cleared of Chlamydia/Gonorrhea?

    TQ.

  2. Hi Dr Tan, I read somewhere that chlamydia in the throat is almost non-existent to the point where doctors won’t worry about it. If that’s the case, can I get chlamydia of the penis if I receive oral sex from someone? If a woman has chlamydia, will i get it in my throat if i perform oral sex on her and accidentally ingested some of her fluid?

    Thanks in adv!

  3. Hi Doctor,

    3 months post exposure I went for a chlamydia/gonorrhea urine test and the results came back negative. 1 month after that i started encountering symptoms (discharge and discomfort) and went for another test, which came back chlamydia and gonorrhea negative as well for both the urine test and urethral swab. The doctor prescribed me antibiotics (cipro and doxycycline), which cleared up the symptoms.

    3 weeks after that the symptoms came back again (discharge, no discomfort) and again, the urine test came back clear of chlamydia and gonorrhea, but the doctor prescribed me another round of antibiotics just to be sure, which cleared up the symptoms again.

    1 week after the last course of antibiotics, and went back for a urethral swab again and the doctor said the white blood cell levels are low and should not be a concern anymore. However, it has been 1 week since my last doctors’ appointment and the symptoms have returned again (clear discharge in the morning).

    I am at my wits’ end, and very frustrated with what’s going on. If it is not chlamydia or gonorrhea, what could be causing this discharge after completing 2 courses of antibiotics?

    Thanks doctor.

    • Dr Justin Sim

      It is difficult to say what may be causing this discharge, especially since you have had negative tests and have had 2 rounds of antibiotics. Clear discharge can be misleading because sometimes small volumes of urine or semen can be mistaken for clear discharge and this is normal. They only other way to be able to tell would be to catch a sample of the discharge and get that tested instead of testing the urine.

  4. unknown

    Hello doc, I’m really confused. I’ve read online that Chlamydia test is done only through urine. However, my doctor took my blood for Chlamydia and Gonorrhea which he said will be cultured for 5 days. Is he doing the right thing?

    • Dr Justin Sim

      Have a look at my answer to your other post for more information.

  5. Hi Dr Tan, I have being discharge in my vagina for more than 5yrs now have done several test like HVS,pelvic scan and taken lots of antibiotics and injections but still this discharge never stops with a foul smell. My pelvic scaN shows dat my right pelvic is okay. Two days I have being seeing blood in my urine with a burning sensation and having pains in the left side of my vagina. Please doctor I would like to know what my problems are, what to do and if the discharge can make one become lean in stature and the reasons for the Pain and blood in the urine. Lian

    • Blood in the urine with burning pain passing urine is almost always symptoms of a bladder infection. Please see your doctor. As for the discharge, you have seen many doctors and done many tests over 5 years. I honestly doubt I can add anything more to that over an internet blog.

      • Am in nigeria doctor please is there drugs you think you could help me with For me to get am very scared of my life.

        • Lian, i used to work in Nigeria. I recommend you to go to SOS International SMI Clinic. The Doctors are expats.

  6. Hi doc,
    Are the treatments for chlamydia the same as prostatitis? Also, if I am tested to be positive for the former, would the reports and my details be sent to MOH?

    • Prostatitis can be caused by a Chalmydia infection. If it is, the medicines used are the same bu the treatment duration is different.

      • Hello Dr. Tan I ask about I have BF first I meet no problem and second meet him after two months he got problem he got pain in his back and going to his tummy and in his cock and he got little problem to urine little pain and he feel cold and diarrhea for almost two weeks and the Dr told him that may be he got chlamydia how come I don’t have sex contact in any body only him and he told he is too but when I got sex I have more bleeding after like a menstruation .but before he use for me a vibrator because he cant go inside in my pussy is possible to have chlamydia?

        • Dr Justin Sim

          Very possible to have chlamydia. The only way to know for sure is to get tested.

  7. Hi Doc Tan, just want to check with you, as I just read up that CT is not only restricted to the reproduction organs but it can also affect the throat and eyes. My question is, I recently did a CT urine test and it was negative. So does that mean I am totally cleared of it, be it the sexual organs or eyes and throat?

    • Yes CT can infect the throat and eyes. Unfortunately, a urine test only detects CT in the urethra or urinary tract. To be completely sure you do not have CT, you should also swab the throat and eyes. Because this is not common and because the PCR test for CT is expensive in Singapore, we do not do those tests as routine.

      • Thanks for the reply doc. May I know what are the symptoms to look out for if assuming there is an infection of the throat or eyes.

        • Most do not have any symptoms. Some will have a mild sore throat and/or red eyes.

  8. Dear Dr Tan,

    I recently had a Chlamydia antibody test performed by my doctor. They telephoned and left a message advising that my result was 64 and that I do not have a current infection. Can I ask please does the reading/level of 64 indicate that I have had a previous chlamydial infection by this I mean does the fact that there is/are a value/antibody present at all mean that this is a sign of a previous infection? I am a little confused as to what the result means. Thank you so much for your help.

    • I haven’t the foggiest idea. Chlamydia antibody blood tests are completely useless and should not be even done. The results are meaningless.

      • Doctor

        1) do white pustules on nose and neck a symptom for Chlamydia?
        2) can it appear within 2 days of exposure?
        3) what is the right period after exposure to get comprehensively tested for non HIV std?
        4) tests results at your clinic for stds are not anonymous but confidential? Are they shared with any insurer or govt agency?

        Thank you

        • Dr Justin Sim

          White pustules are not a feature associated with Chlamydia – but without seeing them myself I wouldn’t be able to tell what may be causing it. Usually non-HIV related HIV STD can be picked up as early as 3-5 days after exposure but symptoms may usually appear a few days later. HIV can be tested anonymously but non-HIV tests are done confidentially. They are not notifiable disease so we do not need to share the information with any insurer or government agency.

          It may be best for you to get tested anyway for peace of mind.

        • 1. No. 2. Possible but very rare. 3. For Chlamydia it can be as early as 3 days or whenever there are symptoms. 4. Completely confidential. Your medical records are not shared with anyone but you.

          • Hi Dr.
            I have been bleeding in between period For some months. I was prescribed to use ornilox , doxycline and mycoten insert. After using for the duration I still had bleeding between period. Any advice on cause. Really looking forward to your response

          • There are many possible causes of mid-cycle bleeding from something as benign as ovulation to something as sinister as cancer. You need to see your doctor for a proper assessment to find out exactly what is causing your bleeding.

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