Chlamydia

What is chlamydia (Klam-id-eeya)?

Chlamydia is actually a group of different bacterial infections caused by various strains of the bug. While Chlamydia pneumoniae can cause a type of pneumonia, and Chlamydia psittaci can cause another type of pneumonia (related to bird exposure), it is Chlamydia trachomatis that is responsible for a multitude of sexually transmitted disease symptoms. Chlamydia is one of the more, if not most common STD.

How is chlamydia diagnosed?

There are several ways in which your physician here at L'Actuel may diagnose chlamydia. The diagnosis may be made by isolating the Chlamydia bacteria in a culture (need to grow the bug), or by finding evidence of the bacteria's unique DNA (genetic material) in a urine or vaginal sample. In the case of an STD screen in women, the gynecological examination is extremely important in the identification of several STD and non-STD infections. During the speculum examination, a cervical swab is performed (a simple brushing of the cervix) and sent to the laboratory. In men, diagnostic techniques have been improved upon, and a simple (and painless!!) urine sample replaces the old swab in the urethra test...ouch no more!

What are the symptoms of Chlamydia?

"One of our biggest concerns at l' Actuel is the frequent lack of symptoms in the presence of chlamydial infections." The real numbers of people who are infected, yet don't know it varies tremendously due to geographic region, age, sex, etc. It is felt that most people infected with chlamydia are not aware of their infections and therefore may not seek health care. Estimates of asymptomatic chlamydial infection range from 40% to 70%, indicating that the true number of chlamydia cases may be much higher than reported. Despite the lack of symptoms...the infection may still be transmitted.

When symptoms do occur, they may begin in as little as 5-10 days after infection, however, there may be very long periods of time before symptom onset. Symptoms may be intermittent is some people, often a reason why help and treatment is not sought. If you are not sure, or think you may be at risk now or in the past, consult your doc!

Women and chlamydia:

When women have symptoms, they may experience:

• bleeding between menstrual periods
• vaginal bleeding after intercourse
• abdominal pain
• painful intercourse
• low-grade fever
• painful urination
• the urge to urinate more than usual
• cervical inflammation
• abnormal vaginal discharge
• mucopurulent cervicitis (MPC) — a yellowish discharge from the cervix that may have a foul odor
• Recall! 40 - 70 % of infected individuals don't have any symptoms!

Men and chlamydia:

When men have symptoms, they may experience:

• pus or watery or milky discharge from the penis
• pain or burning feeling while urinating
• swollen or tender testicles (orchitis and/or epididymitis)
• Recall! 40 - 70 % of infected individuals don't have any symptoms!

These symptoms are like the symptoms of gonorrhea. They are called nongonococcal urethritis (NGU). Men often don't take these symptoms seriously because the symptoms may appear only early in the day and can be very mild.

In women and men, chlamydia may cause the rectum to itch and bleed. It can also result in a discharge and diarrhea (proctitis). If it infects the eyes, chlamydia may cause redness, itching, and a discharge.

There are strains of chlamydia that are responsible for another sexually-transmitted disease, called lymphogranuloma venereum . This disease is seen more commonly in underdeveloped countries but has world-wide distribution. In the United States it is seen more commonly in homosexual men and is a cause of proctitis and colitis (inflammation of the lower intestine).

Chlamydia infection is often found in conjunction with gonorrhea. People who are diagnosed with gonorrhea should also be evaluated for chlamydia infection.

How is chlamydia spread?

Chlamydia may be spread during sexual intercourse via the exchange of bodily fluids through mucous membranes in the anus, mouth, and genital areas. This means that chlamydia is primarily spread through unprotected penetration (vaginal or anal) and/or oral sex (fellatio or cunnilingus - infrequent). It can also spread from a woman to her fetus during birth.

How many people have chlamydia?

The government of Candada keeps statistics on the trends concerning sexually transmitted diseases, including chlamydia trachomatis. Please refer to the statistics report link below.

How is chlamydia diagnosed? This is NOT a painful procedure!

• examination of the cervix (entrance to the uterus) and and a swab (collection on a Q-tip ) of any observed cervical discharge
• laboratory tests of cells from the penis, cervix, urethra, or anus may be used. This entails the use of Dacron or cotton-tipped swabs to obtain samples...only painful when employed in the urethra or conduit of the penis. ***this test is no longer recommended for penile/urethral testing (hooray!!)
• examination of urine samples - a more civilized approach to urethral testing.

***Pap tests sometimes suggest that chlamydia tests are needed. They should not be relied upon as a check for chlamydia.

Gonorrhea and chlamydia may have similar symptoms. It is important to tell them apart. Certain medications can kill gonorrhea but don't work for chlamydia. Other sexually transmitted infections may hide the symptoms of chlamydia.

Is there a cure for chlamydia?

Fortunately, yes! Chlamydia is easy to treat, once it is identified. Both partners must be treated at the same time. Antibiotics are prescribed to kill the chlamydia bacteria. Doxycycline or azithromycin are the preferred treatments. Azithromycin is taken in one dose. Although doxycycline costs less, it must be taken for seven days. Penicillin does not succeed in killing chlamydia.

Other categories of antibiotics including ofloxacin, erythromycin, and erythromycin ethylsuccinate are also prescribed to cure chlamydia. Erythromycin is often prescribed for pregnant women and other people who cannot take tetracycline. It is also used to treat infants with eye infections or pneumonia caused by chlamydia. Your doctor can help you decide which is the best treatment for you. Seek advice.

If you are treated for chlamydia, or any other sexually transmitted infection, remember:

• Take all the prescribed medicine. Even if the symptoms go away, the infection may still be in your body.
• Make sure your partner(s) is/are treated at the same time so you don't reinfect each other - our goal is complete erradication
• Do not share your medicine with anyone.

What if I don't treat my chlamydia? Is chlamydia dangerous?

Diagnosed, chlamydia can be easily treated and cured as described above. Chlamydia is a serious health threat, especially for women. Untreated, chlamydia can cause severe, costly reproductive and other health problems which include both short- and long-term consequences, including pelvic inflammatory disease (PID), which is the critical link to infertility, and potentially fatal tubal pregnancy. PID can scar and block the fallopian tubes. That can make a woman sterile and unable to get pregnant. Fertilized eggs may not reach the uterus because tubes are blocked. If they develop in the tubes, this is called an ectopic pregnancy or tubal pregnancy. A woman may die if a pregnancy develops outside her uterus. She usually needs emergency surgery. Women with PID of the fallopian tubes are 7-10 times more likely than other women to have ectopic pregnancies.

Chlamydia can also make men sterile. It can spread from the urethra to the testicles. Then it can result in a condition called epididymitis. Epididymitis can cause sterility. Symptoms include fever as well as swelling and a variable degree of pain in the scrotum.

Chlamydia may also result in adverse outcomes of pregnancy, including neonatal conjunctivitis (newborn eye infections) and pneumonia. In addition, recent research has shown that women infected with chlamydia have a 3 - 5 fold increased risk of acquiring HIV, if exposed.

What are the symptoms of PID?

The symptoms of PID include:

• longer and/or heavier periods
• more cramping during periods
• abnormal mucus discharges
• pain in lower abdomen
• tiredness, weakness
• fever
• vomiting
• pain during vaginal intercourse
• pain during pelvic exam

How does chlamydia affect pregnancy?

Between 20 and 50 percent of children born to women with chlamydia will be infected. Chlamydia is the leading cause of neonatal conjunctivitis — an eye infection that can cause blindness. Symptoms usually begin within four weeks of birth.

These children can also develop chlamydia pneumonia, a kind of pneumonia that can be fatal. This infection is harder to treat in infants than adults.

Chlamydia also may cause heavy bleeding before delivery. It might cause membranes to break early, resulting in premature delivery. It also may be connected to miscarriage, stillbirth, or low birthweight.

Fortunately, treatment of chlamydia is successful in nine out of ten pregnant women. Antibiotics must be chosen carefully during pregnancy, so make sure to consult your doctor.

Who is most likely to get chlamydia?

• people who have several different sex partners
• people whose sex partners have a number of different sex partners (and so on, and so on…)
• people who don't use condoms
• people with a history of other sexually transmitted infections
• Women who contract chlamydia while using the IUD (the intra-uterine device) are at higher risk of developing PID because the bacterium has a direct and rapid access to the upper genital tract. That is why only women in stable, monogamous relationships are advised to use the IUD.
• sexually abused children

Young adults have the highest rates of chlamydia. Persons who have more than one sex partner, especially women under 25, should be tested for chlamydial infection regularly, even in the absence of symptoms.

How can people with chlamydia avoid spreading it?

• Inform your sex partners of the infection (or ask your physician to help you in contact tracing and treatment)
• Have no sex until treatment is complete (oral sex included) - or use barriers (condom, dental dam, etc.) for all sexual contact..."safe sex".
• Be sure that your sex partner(s) are screened and treated at the same time.
• Use female or male condoms every time.
• All sexual contacts should be screened for chlamydia. Sexual partners must be treated to prevent passing the infection back and forth between them, even though both may not have symptoms. There is no immunity following the infection and a person may become repeatedly infected.
• Ensure proper handwashing during treatment so as to prevent the transfer of the infection to your eyes.

How can I avoid getting chlamydia?

• Use a female or male condom every time.
• Have routine checkups for sexually transmitted infections - discuss the frequency with your doc
• Aside from total abstinence, a monogamous sexual relationship with a known healthy partner is the best way of avoiding this and all other sexually-transmitted diseases. Condoms remain the best and most reliable protection against this and other sexually-transmitted diseases for sexually active people. Condoms should be used consistently and correctly when any sexual behavior falls outside abstinence or monogamy with a healthy partner. Consider using a condom or dental dam for oral sex, particularly if the risks are unknown.

A review of what's new!

Recent research advances have made available extremely accurate urine tests which make testing of males more feasible and less uncomfortable than older tests. In addition, single-dose antibiotic therapy promises to substantially enhance the likelihood of successful treatment -- especially in adolescents -- as compared to commonly used 7-day oral medication. Seek help from your doc! Prevention is the best bet; condoms for penetration are not new, however, flavored or flavorless condoms for oral sex (fellatio) do exist! Dental dams, or a sheet of latex used to cover the female external genitalia may be used to practice safe cunnilingus and are more widely available than in the past. Visit your local pharmacist or condom shop.