Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 22, 2016

Chlamydia is a sexually transmitted disease (STD) and is the most prevalent type of bacteria-caused sexually transmitted disease reported in America. It is spread by direct sexual contact and can infect the penis, vagina, cervix, and rarely the eyes or throat, and is especially common in men and women under the age of 25.


Definition & Facts

Chlamydia is a bacterial infection that can cause severe and painful complications in both women and men. According to the CDC, it is the most commonly reported STD in the United States, with over 1.4 million reported cases in 2014, and an estimated 2.86 cases annually. It is over three times as prevalent as gonorrhea and over 50 times as common as syphilis.

Symptoms & Complaints

Most cases of chlamydia are asymptomatic; about 70-90% of all women and about 90% of men with chlamydia do not realize they have an infection because they do not present with noticeable signs of infection.

Those that do experience symptoms of the infection may present with a variety of complaints. Women may experience any or all of the following symptoms: abdominal pain, abnormal vaginal discharge, yellowish cervical discharge, low grade fever, pain during intercourse or bleeding following intercourse, frequent urination, pain or a burning sensation while urinating, and swelling in the vagina or swelling in the anus.

Men may experience pain or a burning feeling during urination, pus or a milky discharge from the penis, swollen testicles or tender testicles, and anal itching, anal bleeding, and anal swelling. In the case of throat infection, there may be a sore throat, and if the eyes are infected they may be red, itchy or have discharge.

Many of the symptoms may be mild or may only occur in the morning, particularly with infected men. If chlamydia is overlooked or not treated in time, it may spread to the testicles and cause pain and fever, and in rare occurrences cause complications that lead to sterility for men. In women, untreated chlamydia may spread to the uterus and Fallopian tubes which can cause irreversible reproductive system damage, pelvic pain and pelvic inflammatory disease (PID).

If a women is pregnant or expects to become pregnant, it is very important to seek testing and treatment as the risk of miscarriage and ectopic pregnancy are increased with pelvic inflammatory disease. Pregnant women with chlamydia face an increased likelihood of preterm labor and premature birth, and risk the possibility of transmitting the infection during childbirth which may cause pneumonia or an eye infection in the baby.


Chlamydia is caused by sexual contact with infected partners, primarily through unprotected vaginal intercourse and anal intercourse, and is rarely passed though oral sex. It is very rarely passed by touching the eyes with a hand contaminated with infectious body fluids. Ejaculation does not need to occur to transmit the disease.

Diagnosis & Tests

Options that healthcare providers can use to diagnose chlamydia may include body fluid or urine testing, visual detection of symptoms during an exam, or by direct sampling, which is done by taking swabs or cell samples from the suspected infected tissue for laboratory testing or cultures.

If a patient will be having a direct sample taken, it is important to abstain from intercourse or inserting anything into the infected area, including medicinal creams or treatments, for at least 24 hours prior to the test. Samples are collected from men by swabbing the opening of the urethra or anus, and from women by swabbing the cervix and vaginal walls or anus. Direct sampling is a quick procedure that may cause minor pain and discomfort, and women may experience cramping during the procedure. If an infection is found, all sexual partners should be disclosed so that they can receive treatment and reduce further transmission.

Treatment & Therapy

Treatment of chlamydia involves antibiotic therapy and depending on the course of treatment may last from one to seven days. The two most common antibiotics prescribed for treatment are: azythromycin, a single-does treatment that is often administered in the clinic or doctor’s office; and doxycycline, which involves multiple doses over a seven day course of treatment.

Other courses of treatment are available and may be prescribed at the discretion of the patient’s health care provider. The infected person should abstain from all sexual contact until they are cleared of the infection, and it is recommended they take a follow up test three months after diagnoses to ensure they are free of the disease.

Prevention & Prophylaxis

Chlamydia can be prevented by abstaining from oral sex and vaginal and anal intercourse. Transmission may also be prevented by using barrier methods like female or latex condoms, or dental dams if engaging in oral sex, with partners being sure to use a new, unused prophylactic for each incidence of direct sexual contact.

Regular STD testing is vital for a sexually active person with multiple partners or if their sexual partners are sexually active with people who have not been tested, as screening is the primary way the disease is detected. If someone is diagnosed with chlamydia it is important to complete the prescribed treatment and not to spread it to anyone else.

They must abstain from sexual contact throughout the duration of the treatment and to inform all sex partners of the infection so they may get tested and treated if necessary. It is also important for all partners to get tested and receive thorough treatment before resuming sex to avoid re-transmission. Annual testing is recommended especially for pregnant women, people under the age of twenty five and for people of all ages and sexual orientations with new or multiple sexual partners.