What Is Chlamydia: What You Need to Know

Luisa Kindinger

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What is chlamydia? A chlamydia infection is the most common sexually transmitted disease worldwide. However, most people affected by chlamydia do not even know they’re infected, which can lead to serious complications such as painful infections and infertility. 

Chlamydia infections have been on the rise worldwide since the end of the 1990s: With more than 80 million new infections every year, chlamydia is the most common sexually transmitted infection. Alongside HPV infections, chlamydia affects more people than other STIs, such as syphilis and gonorrhea.[1, 2]

Chlamydia infections often go undetected because there are often no symptoms. If the disease progresses, serious secondary diseases and complications can develop. Chlamydia is the most frequent cause of inflammation-related infertility.[3]

Find out everything you need to know about chlamydia, including who is at risk of chlamydia, chlamydia symptoms, chlamydia prevention, and what other consequences an infection can have.

What Is Chlamydia?

Chlamydia is a sexually transmitted infection (STI) caused by the small bacteria Chlamydia trachomatis. These settle mainly in human mucous membranes; outside of which they can hardly survive.

In the United States, the Centers for Disease Control and Prevention reported that over 1.8 million people contracted chlamydia in 2019 – an increase of 2.8 percent compared with the previous year.[15] In 70 percent of cases, a chlamydia infection doesn’t trigger any symptoms, meaning that many of those affected do not know that they have contracted chlamydia.[4] This is highly problematic because many sufferers can then go on to infect other people unknowingly.

How Is Chlamydia Transmitted?

Chlamydia is transmitted through sexual contact.[5] The pathogen can be transmitted during sexual intercourse through vaginal fluid, semen, as well as during oral and anal sex. Contaminated sex toys can also cause infection.[6] Chlamydia can furthermore be transmitted from a mother to her infant during pregnancy.[16]

Chlamydia is transmitted almost exclusively through sexual contact – transmission through kissing, sharing towels, dishes, or toilets, or in swimming pools is unlikely.[6, 7]

Why Is Chlamydia So Dangerous?

An undetected chlamydial infection can lead to severe long-term health issues such as:[2, 4]

  • Sterility or infertility
  • Chronic lower abdominal pain
  • Implantation of a fertilized egg outside the uterus (ectopic pregnancies)
  • Premature births
  • Fistulas and inflamed and swollen mucous membranes

Did you know that doctors refer to a woman as infertile when pregnancy does not occur despite regular sexual intercourse for at least one year? Infertility also means that a woman can become pregnant but cannot carry the child to term.[6]

Newborns of women suffering from chlamydia can contract conjunctivitis, ear infections, and pneumonia, among other health issues.[4]

woman holding her stomach in pain

Who Is at Particular Risk of Contracting Chlamydia?

The risk of becoming infected with chlamydia increases especially if you have sex with different partners. People in their twenties and thirties are most frequently affected.[5]

Other particularly frequently affected risk groups include:[6]

  • young women between 15 and 24 years,
  • young men between 15 and 29 years, and
  • men who have sex with men (MSM).

What Are Common Chlamydia Symptoms?

What does chlamydia look like? A chlamydia infection progresses differently for men and women and can also lead to different secondary diseases. After becoming infected with chlamydia, it takes about one to three weeks for chlamydia symptoms to appear – if any develop at all.[6]

What many do not know is that chlamydia can be transmitted through sex by more than just the genitals. Infections can also occur in the mouth, throat, or anal area after oral or anal sex, leading to inflammation in the pharyngeal mucosa or the intestinal mucosa.

The most common chlamydia symptoms include: 

  • Itchiness
  • Lower abdominal pain
  • Burning during urination
  • Bleeding between periods
  • Pain during sexual intercourse

If an infection remains undetected, the pathogen spreads to the fallopian tubes and ovaries in 10 to 40 percent of those affected. There, chlamydia can lead to scarred tissue and thus to blockages in the passage of eggs. This can result in ectopic pregnancies and sterility, among other things. Other organs can also be affected from the fallopian tubes and ovaries and become inflamed.

How Long Can an Ectopic Pregnancy Go Unnoticed?

Up to three percent of all pregnancies are ectopic pregnancies. A chlamydia infection can increase the likelihood of an ectopic pregnancy.[9]

In an ectopic pregnancy, a fertilized egg is not found in the uterus, but often in the fallopian tubes, for example.[10] There, the fertilized eggs do not receive the nutrient supply they need. The skin surrounding the implanted egg gradually swells and can rupture after 6 to 16 weeks; this results in severe bleeding, which can even be life-threatening.

Chlamydia in Men: What Does Chlamydia Look Like?

Chlamydia symptoms for men are different – this is why men notice a chlamydia infection more often than women. For them, only 50 percent of cases are asymptomatic. When a man’s urethra is affected, the following symptoms can occur during urination:[1]

  • Feeling of pressure
  • Pain
  • Burning

If a chlamydia infection remains untreated, this can lead to a pus discharge or itching. As the infection progresses, the pathogen may spread to the prostate or epididymis, leading to painful inflammation and swelling.[6]

An untreated infection can also lead to infertility in men.[11] Advanced chlamydial infection in men can also lead to joint inflammation, tendonitis, and, in rare cases, conjunctivitis.

Did you know that chlamydia often affects men with gonorrhea? According to the German health organization, the Robert Koch Institute, 15 percent of chlamydia cases in men reported to them were also positive for gonorrhea.[5]

Chlamydia Prevention: How Can I Protect Myself from an Infection?

woman opening condom wrapper

Anyone who is sexually active can becoming infected with chlamydia – that’s why it’s important to make sure you are doing all you can when it comes to preventing chlamydia transmission. If you acknowledge the following recommendations for chlamydia prevention, you can considerably reduce your risk of contracting the disease – even if infection with chlamydia cannot be ruled out one hundred percent when using condoms, for example:[4]

  • Protect yourself and your sexual partner by using condoms – also during oral and anal sex
  • Clean sex toys carefully before and after use
  • Wash your hands thoroughly before and after contact with body fluids
  • If you change sexual partners frequently or experience discomfort in your genital area, consult your doctor and have yourself tested for sexually transmitted diseases

Chlamydia Diagnosis: What Test Is Used to Detect Chlamydia?

Chlamydia can be diagnosed in several ways. Doctors usually order a urine sample or take a swab.[4] With swab testing, chlamydial infections can only be detected 10 to 14 days after infection. This type of testing involves wiping an infected area, such as inside the anus, with a cotton swab. Rapid tests using swabs have also been shown to be unreliable.

Blood tests are also not the gold standard for diagnosing chlamydial infections, as chlamydial antibodies can only be detected in blood six to eight weeks after infection, and these antibodies remain in the blood for months to years after the infection has cleared.[6]

If you take a urine test, your bladder should not be emptied for at least one to two hours beforehand? This is called a clean catch sample; bacteria are best detected in your urine straight after you get up in the morning.[6]

You do not always need an in-person examination by your nurse or doctor – you can also visit a sexual health clinic to be tested for chlamydia. You can also buy at-home chlamydia tests – as well as other STD home test kits – from various online health product providers. You should not delay getting tested for chlamydia if you suspect you may be infected!

Why Should I Take a Chlamydia Test?

You should take a chlamydia test in any of the following instances:[17]

  • if you or your partner have any chlamydia symptoms
  • if you’ve had unprotected sex with a new partner
  • if you use condoms inconsistently or incorrectly – or if a condom splits while you’re having sex
  • if you think you could have other STIs – especially if you have HIV
  • if a sexual partner tells you they have an STI
  • if you’re pregnant or planning to get pregnant

Chlamydia Treatment: Can You Completely Cure Chlamydia?

Chlamydia can be successfully treated with antibiotics. Chlamydia treatment typically takes one to three weeks.[2] However, if the infection has caused scarring and damage to the tissue, this cannot be reversed. That is why diagnosing and treating chlamydia as early as possible is so important.

During chlamydia treatment, you should avoid having sex until you and your sexual partner have finished the course of treatment.

After treatment of chlamydia, a smear test or urine test is usually performed to check the success of treatment and to rule out re-infection [6].This is how you protect yourself from chlamydia.

Can Chlamydia Come Back?

You should inform your sexual partner if you are infected. Partners should equally be tested for a chlamydia infection, so that they know whether or not they also need to undergo chlamydia treatment and avoid re-infection – you can theoretically become re-infected with chlamydia again and again.[12]

Young adults who test positive for chlamydia are at increased risk of becoming infected again.

    What Is Chlamydia – at a Glance

    What Is Chlamydia?

    Chlamydia trachomatis is a bacterium that is responsible for the sexually transmitted disease chlamydia.

    The disease progresses differently for men and women and can each lead to long-term inflammation and infertility if left untreated.

    What Are Chlamydia Symptoms?

    What does chlamydia look like? A large proportion of chlamydia infections are asymptomatic. Only 20 percent of women develop symptoms such as itching, burning when urinating, intermittent bleeding, and pain.

    Men are more likely to have symptoms: About half of affected men notice itching, burning, or pressure when urinating, as well as pain and swelling in the genital area.

    Are There Measures for Chlamydia Prevention?

    To protect yourself from a chlamydia infection, you should protect yourself and your sexual partner by using condoms – also during oral and anal sex. You should also clean sex toys and your hands before and after contact with with bodily fluids. Furthermore, you should also ensure that you regularly test yourself for STIs if you change sexual partners frequently.

    How Does Chlamydia Treatment Work?

    Chlamydia can be treated successfully with antibiotics. However, any damage that has occurred does not automatically heal along with it, which is why early diagnosis and treatment of the infection is vital!

    Sources

    [1]       Unbemerkte Gefahr, DAZ.online, February 27, 2014, available at https://www.deutsche-apotheker-zeitung.de/daz-az/2014/daz-9-2014/unbemerkte-gefahr, accessed on June 14, 2021.

    [2]        Briken, P., Berner, M. Praxisbuch Sexuelle Störungen: Sexuelle Gesundheit, Sexualmedizin, Psychotherapie sexueller Störungen, Georg Thieme Verlag, 2013.

    [3]        Strowitzki, T. Infertilität bei Frauen, Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz, vol. 56(12), pp. 1628–1632, 2013.

    [4]        Neumann, G., Feucht, H. H., Becker, W., Späth, M. Gynäkologische Infektionen: Das Handbuch für die Frauenarztpraxis-Diagnostik-Therapie-Prävention, Springer-Verlag, 2011.

    [5]       RKI - RKI-Ratgeber - Chlamydiosen (Teil 1): Erkrankungen durch Chlamydia trachomatis, available at https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Chlamydiosen_Teil1.html;jsessionid=DECE0D81EDF9B769144D6142DFEB7FAD.internet071, accessed on June 08, 2021.

    [6]        Broschüre: Chlamydien - Frühzeitig erkennen und behandeln,” Bundeszentrale für gesundheitliche Aufklärung.

    [7]       Pschyrembel Online | Schwimmbadkonjunktivitis, available at https://www.pschyrembel.de/Schwimmbadkonjunktivitis/K0KM4, accessed on June 21, 2021.

    [8]       Chlamydien-Test für Frauen bis 25 Jahre - Gemeinsamer Bundesausschuss, available at https://www.g-ba.de/themen/methodenbewertung/ambulant/frueherkennung-krankheiten/erwachsene/chlamydien-test/, accessed on June 15, 2021.

    [9]        Kainer, F. Facharzt Geburtsmedizin, Fischer Gustav Verlag GmbH & Company KG, 2015.

    [10]     Wie Chlamydia ektopische Schwangerschaft fördert, AerzteZeitung.de, available at https://www.aerztezeitung.de/Medizin/Wie-Chlamydia-ektopische-Schwangerschaft-foerdert-284823.html, accessed on June 14, 2021.

    [11]     Genitale Chlamydien-Infektionen: Symptome, Vorbeugung und Behandlung, gesund.bund.de, available at https://gesund.bund.de/chlamydien, accessed on June 17, 2021.

    [12]     Chlamydien » Prävention & Chlamydien-Screening », available at https://www.frauenaerzte-im-netz.de/erkrankungen/chlamydien/praevention-chlamydien-screening/, accessed on June 15, 2021.

    [13]      Bundesamt für Gesundheit, Chlamydiose, available at https://www.bag.admin.ch/bag/de/home/krankheiten/krankheiten-im-ueberblick/chlamydiose.html, accessed on June 22, 2021.

    [14]     Geschlechtskrankheiten sind in Österreich auf dem Vormarsch, trend.at, May 25, 2015, available at https://www.trend.at/service/gesundheit/geschlechtskrankheiten-oesterreich-vormarsch-5670003, accessed on June 22, 2021.

    [15]      National Overview – Sexually Transmitted Disease Surveillance, 2019, Centers for Disease Control and Prevention, available at https://www.cdc.gov/std/statistics/2019/overview.htm#Chlamydia, accessed on August 30, 2021.

    [16]      Overview: Chlamydia, National Health Service, available at https://www.nhs.uk/conditions/chlamydia/, accessed on August 30, 2021.

    [17]      “Diagnosis: Chlamydia,” National Health Service, available at https://www.nhs.uk/conditions/chlamydia/diagnosis/, accessed on August 30, 2021.

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