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Chlamydia

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Chlamydia

Written by Dr Angela Robinson, consultant in sexual health

What is chlamydia?

Chlamydia is a sexually transmitted infection (STI) caused by a tiny bacterium, Chlamydia trachomatis.

If you haven't heard of chlamydia, you're in good company â€“ a substantial proportion of the UK population hasn't either.

Many people who are at risk of this infection don't really know what it is, or understand it, even if they are aware of the name.

Why should I know about it?

Chlamydia is the most common STI in the UK. It affects both sexes, although young women are more at risk.

Chlamydia can be treated, but it often has no symptoms in either men or women, so remains undetected.

Infection may only be diagnosed once chlamydia has led to complications - when treatment can sometimes be too late to stop permanent damage.

Are there any symptoms?

Good advice Get yourself tested if you think you have been at risk of infection.

What complications can chlamydia cause?

In some women chlamydia can cause pelvic inflammatory disease (PID), also know as pelvic infection. It can damage the Fallopian tubes that carry eggs from the ovaries to the womb. The tubes may stop working properly and can become completely blocked.

Chlamydia is the most common preventable cause of infertility in women. When the Fallopian tubes are blocked, no pregnancy is possible naturally. One option is IVF (in-vitro fertilisation), but availability on the NHS is patchy and has variable success rates.

Women with damaged tubes do occasionally fall pregnant, but there is an increased risk of the pregnancy developing in the tubes rather than the womb. This is called an ectopic pregnancy. The tube can split apart causing serious pain and bleeding. This is an emergency, because the bleeding can be life threatening.

Infection sometimes leads to pain in the lower abdomen that is often mistaken for some other problem rather than pelvic infection.

Chlamydia infection can affect sperm function and male fertility. It is the most common cause of inflammation in the testicles and sperm-conducting tubes (epididymo-orchitis) in men under the age of 35. This causes pain, swelling and redness on the affected side of the scrotum, or on both sides.

Chlamydia can also trigger joint inflammation in some men. Although this is uncommon, it can be difficult to treat.

What problems do the lack of symptoms cause?

The UK's genitourinary medicine (GUM) clinics form one of the best networks in Europe to diagnose and treat STIs. But people often have no reason to suspect they have chlamydia, so they don't seek advice at one of these clinics.

Apart from sexual health experts, many doctors may not suspect chlamydia when assessing a person's symptoms, so don't do an appropriate test.

Healthcare professionals are often unaware of how common chlamydia is and that it can be present without causing symptoms.

How do I know if I should be tested?

Chlamydia is almost always transmitted through sexual intercourse, so the likelihood of having the infection depends on your sexual behaviour.

If you've had sex and not used a condom, you are at risk of chlamydia.

The more partners you have, the more likely you will be exposed to infection. This isn't about promiscuity - you only need to have unprotected sex with one person who happens to have the infection to get chlamydia.

In a recent survey of young male army recruits, almost 10 per cent proved positive on chlamydia urine tests. Eighty eight per cent of the men who tested positive had no symptoms whatsoever.

Good advice Make sure your friends have heard about chlamydia and its consequences.

Encourage them to get a check-up if they think they are at risk.

Young women

Chlamydia is most common and most likely to cause serious complications in younger women.

If you are under 25 and sexually active, you have a 1 in 10 chance of having chlamydia, so it is worth getting tested.

Your risk is even higher if you are under 20 and have had unprotected sex.

If you are over 25 and have had two partners within a year, or recently changed partner, your risk is also increased.

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