Chlamydia

Chlamydia is a sexually transmitted disease (STD).


Causes/associated factors
Chlamydia is caused by the Chlamydia trachomatis bacterium. About 3 million cases are diagnosed in the United States each year. People who face the highest risk for chlamydia may include those who:
have new or multiple sexual partners
don't use a barrier method of contraception (such as condoms) consistently
are younger than age 25 and sexually active
have had an STD in the past

Transmission
Chlamydia spreads through vaginal, anal or oral sexual contact, regardless of whether the infected person has symptoms.

Signs/symptoms
For most people, chlamydia causes no symptoms. If symptoms develop, they're often mild and typically appear within one to three weeks after exposure to the bacteria. Symptoms may include:
pain or burning with urination
rectal pain, discharge or bleeding
eye redness
for women, vaginal discharge, lower abdominal or back pain, painful sex and difficulty getting pregnant
for men, urethral discharge (from the tube that drains urine and semen to the outside of the body) and testicular pain or swelling

Diagnosis
To diagnose chlamydia, the doctor will ask questions about your medical history and do a physical exam. Then, lab tests will be done on secretions from the vagina, rectum, urethra or other potentially infected site.
A process called DNA amplification can screen urine samples for the bacteria that causes chlamydia. This process is simpler, less invasive and more accurate than older methods of testing.

Many people who have chlamydia also have gonorrhea, another sexually transmitted disease. Your doctor may test for that condition at the same time.


Treatment
Chlamydia can be quickly cured with antibiotics such as doxycycline or azithromycin. Your doctor may suggest another antibiotic if you have medication allergies. Even if your symptoms clear up right away, it's important to take the full course of medication.
If you're diagnosed with chlamydia, notify your sexual partner(s). Anyone you've had sex with needs to be evaluated, tested and treated. It's important to abstain from all sexual activity until you and your partner(s) have completed treatment.

For women, follow-up testing may be recommended three to four months later, especially if it's unclear whether the sexual parrtner(s) have been treated.


Complications
Chlamydia can lead to serious complications, even when there are no symptoms.
For women, chlamydia can cause pelvic inflammatory disease (PID) by spreading from the cervix through the uterus and into the fallopian tubes. This condition can cause chronic abdominal pain. It can also permanently scar the fallopian tubes, leading to infertility. About 1 million women are diagnosed with PID in the United States each year, and half of PID cases are thought to be caused by chlamydia. PID also increases the risk of ectopic pregnancy (when the fertilized egg implants itself outside the uterus).

Other complications of chlamydia may include:

sterility for both men and women
easier infection with HIV (the virus that causes AIDS)
eye infections or pneumonia for newborns (Antibiotic treatment is also effective for newborns.)
for men, Reiter's syndrome (a condition that causes inflammation of the urethra, joints and lining of the eye) and epididymitis (infection of the epididymis, a tube that carries sperm away from the testes)

Pregnancy-specific information
All pregnant women should be tested for chlamydia.
A chlamydia infection during pregnancy may lead to premature rupture of the membranes or a premature delivery. The infection may spread to the baby during delivery, which may result in newborn eye or lung infections.

The medications of choice for treating chlamydia haven't been established as safe during pregnancy, so alternate medications are used. Erythromycin or amoxicillin are common choices.


Senior-specific information
Growing older is not a risk factor for this condition.

Prevention
Abstinence is the most effective way to prevent chlamydia. If you're sexually active, mutual monogamy with an uninfected partner will reduce the risk of contracting chlamydia and other sexually transmitted diseases. If you're not in a monogamous relationship, reduce the risk of contracting chlamydia and other STDs:
Limit your number of sexual partners.

Make sure each sexual partner is tested for STDs and completes proper treatment, if necessary, before you have sexual contact.

Use a latex or polyurethane condom consistently during any vaginal, oral or anal sexual contact. (Keep in mind that a condom doesnver more surface area. If you choose latex condoms -- the most effective in preventing the spread of STDs -- use only water-based lubricants. The chemicals in other lubricants may break down the latex in the condom.)
Because most chlamydia infections don't cause symptoms, the U.S. Preventive Services Task Force recommends routine chlamydia screening for sexually active women age 25 and younger, all pregnant women, and anyone who has an increased risk of infection. Again, this may include anyone who:

has new or multiple sexual partners
doesn't use a barrier method of contraception (such as condoms) consistently
is younger than age 25 and sexually active
has had an STD in the past