Chlamydia

Chlamydia trachomatis is the most common bacterial sexually transmitted infection worldwide. It is particularly insidious because the vast majority of people infected — approximately 70–95% of women and 50% of men — have absolutely no symptoms.

Despite its silence, untreated chlamydia causes serious long-term damage: Pelvic Inflammatory Disease (PID), fallopian tube scarring, infertility, chronic pelvic pain, and an increased risk of ectopic pregnancy in women. In men, it can cause epididymitis and, rarely, infertility.

When symptoms do occur (usually 7–21 days after exposure):

• WOMEN: Unusual vaginal discharge; burning or pain when urinating; pelvic pain or pressure; pain during sex; inter-menstrual bleeding.
• MEN: Discharge from the penis (clear or cloudy); burning or pain when urinating; swelling or pain in one or both testicles.
• RECTAL infection: Rectal pain, discharge, or bleeding — commonly no symptoms.
• EYE infection (chlamydial conjunctivitis): Eye discharge and irritation, can occur in newborns (neonatal chlamydia).

• Vaginal, anal, or oral sex with an infected person
• Does not require penetration or ejaculation — genital contact is sufficient
• Mother-to-child transmission during vaginal birth

• NAAT (urine or genital swab) — the gold standard. Sensitivity 95%+. Window period: 7–21 days.
• For rectal or throat infections: site-specific swab tested by NAAT.
• Routine testing is strongly recommended for all sexually active people under 25, and for those with new or multiple partners.

Chlamydia is highly curable with a short course of antibiotics:

• Azithromycin 1g — a single oral dose. Highly effective and convenient.
• Doxycycline 100mg twice daily for 7 days — preferred in some cases (slightly more effective for urogenital infection).
• Avoid sex for 7 days after completing treatment (and until partners are treated).
• All partners from the past 60 days should be tested and treated.

• Annually if sexually active under 25
• Before or after each new sexual partner
• During pregnancy (first antenatal visit)
• If any symptoms of discharge, pelvic pain, or burning urination appear
• If a partner has been diagnosed with chlamydia