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We’re all familiar with pop culture’s depictions of the unwelcome sensations that cause someone to seek out a sexually transmitted infection (STI) test. Itching, burning, the appearance of something that shouldn’t be on your genital region—no one wants to deal with these.
But what does chlamydia feel like? Unlike some STIs, it can have vague symptoms or, in most cases, no symptoms at all. Chlamydia is the most common notifiable STI in the United States, largely because it’s asymptomatic in most cases.
However, chlamydia can produce symptoms, and it’s important to be aware of them. Untreated chlamydia can lead to complications, particularly in women.
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What is chlamydia?
Chlamydia is an STI caused by the Chlamydia trachomatis bacteria. It is spread sexually by coming into contact with the anus, mouth, penis, or vagina of an infected person—this includes anal sex, oral sex, and vaginal sex. Ejaculation isn’t necessary for it to be transmitted.
And you don’t have to have any symptoms of chlamydia to infect your sex partners. Infected pregnant women can also spread it to their infants during childbirth.
According to the Centers for Disease Control and Prevention (CDC), chlamydia is the most common notifiable STI in the U.S. In 2018, the CDC estimated four million people were infected with chlamydia—and the rates in the U.S have been rising. Most people do not realize they have a chlamydia infection because the majority don’t have symptoms and don’t get testing (CDC, 2021).
What chlamydia can feel like
Only 10% of men and 5–30% of women who test positive will develop symptoms of chlamydia. When chlamydia does cause symptoms or health problems, it is known as a sexually transmitted disease (STD) (CDC, 2021).
In women, chlamydia usually infects the cervix first, causing cervicitis or inflammation of the cervix, which often leads to pain, irritation, or a vaginal discharge. Left untreated, chlamydia can spread to the cervix, uterus, ovaries, and fallopian tubes, causing abdominal pain or pelvic pain and pelvic inflammatory disease (PID). (Hsu, 2019).
In men and women, chlamydia bacteria can irritate the urethra and lead to urethritis (swelling in the urethra) which causes a burning sensation with urination and discharge. Untreated chlamydia can also cause epididymitis in men. Epididymitis is swelling in the tube in the back of the testicles, causing pain or soreness (Hsu, 2019).
Chlamydia can infect the eyes in both men and women, causing chlamydial conjunctivitis (a type of pinkeye) with corresponding redness, infection, and discharge. Chlamydia can also infect the rectum, either through anal sex or the spread of bacteria from the cervix or vagina. This might produce pain, discharge, bleeding, or no symptoms at all (Hsu, 2019).
Specific strains of chlamydia affect the lymphatic system, leading to lymphogranuloma venereum (LGV). LGV typically presents as a painless ulcer on the genitals, followed by pain and swelling of the lymph nodes in the groin. The infection can spread through the body and also cause fever. LGV can also cause inflammation in the rectum, accompanied by gastrointestinal symptoms (Hsu, 2019).
Before 2003, LGV was mainly found in tropical and subtropical regions of the world and considered rare in developed nations. However, recent outbreaks illustrate that rates are rising in both the United States and Europe, especially in men who have sex with men (MSM) (de Vries, 2019).
Although chlamydia can be found in the throat of people who have oral sex with an infected partner, it generally doesn’t produce symptoms, according to the CDC.
Complications of chlamydia
Untreated chlamydia can cause several complications, most seriously in women.
It’s essential to seek treatment for chlamydia promptly because pelvic inflammatory disease (PID) can cause damage to the female reproductive system. PID can lead to scarring or blockages in the fallopian tubes, raising the risk of infertility or ectopic pregnancy. In the latter condition, a fertilized egg implants in the fallopian tube instead of the uterus. When this happens, it can cause the tube to rupture, potentially leading to shock and severe blood loss—this can be fatal (Hsu, 2019).
Some women with PID can develop Fitz-Hugh-Curtis Syndrome, an inflammation of the liver and surrounding tissues signified by pain in the right upper quadrant (Hsu, 2019).
Chlamydia can also be spread from mother to infant during childbirth, and it can cause premature delivery or pneumonia in the baby (Hsu, 2019).
In rare cases, chlamydia in men can cause prostatitis (inflammation of the prostate), scarring of the urethra, and/or infertility (Hsu, 2019).
Treatment of chlamydia
Most cases of chlamydia are curable with antibiotics—azithromycin and doxycycline are the most common drugs. Azithromycin can be given as a single large dose while doxycycline is used over a week. Your healthcare provider may combine one of those drugs with ceftriaxone to treat gonorrhea (since these STIs often occur together). If you are treating any of the complications of chlamydia, you may need to be on medication for longer.
If you’re diagnosed with chlamydia, don’t have sex for seven days after beginning antibiotics. Inform any sexual partners you had within 60 days about your diagnosis and encourage them to get a chlamydia test and treatment. In general, you should avoid unprotected sex to prevent re-infection and decrease your risk of getting other STIs, like herpes, HPV, gonorrhea, etc.
History of chlamydia
The bacteria Chlamydia trachomatis was discovered in 1907 by a German scientist. “Chlamydia” comes from the Greek word chlamys, which means cloak, and “trachomatis” from the Greek for rough or harsh.
Rates of chlamydia, like other STIs, are rising in the United States. According to a CDC report, there’s been a 22% increase in reported chlamydia cases from 2013 to 2017 (CDC, 2018). Researchers theorize a decline in condom use and cuts in funding for STI education programs may be responsible.
Although chlamydia is most common among young people, the CDC estimates that one in 20 sexually active young women between the ages of 14 and 24 have chlamydia. Anyone who is sexually active can contract it. That’s just one reason why regular STI screening and avoiding unprotected sex are good ideas. Talk to your health care provider about what’s right for you (CDC, 2021).
- Centers for Disease Control and Prevention. (2021, Jan). Chlamydia – CDC fact sheet (Detailed). Retrieved on May 14, 2021 from https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm
- Centers for Disease Control and Prevention (CDC). (2018, Aug). 2018 STD Prevention Conference. Retrieved on May 13, 2021 from https://www.cdc.gov/nchhstp/newsroom/2018/2018-std-prevention-conference.html
- de Vries, H., de Barbeyrac, B., de Vrieze, N., Viset, J. D., White, J. A., Vall-Mayans, M., et al. (2019). 2019 European guideline on the management of lymphogranuloma venereum. Journal of the European Academy of Dermatology and Venereology : JEADV, 33(10), 1821–1828. doi: 0.1111/jdv.15729. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31243838/
- Hsu, K. (2019). Clinical manifestations and diagnosis of Chlamydia trachomatis infections. In UptoDate. Marrazzo, J. and Bloom, A. (Eds.). Retrieved from https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-chlamydia-trachomatis-infections