Chlamydia is a common bacterial sexually transmitted infection (STI). It is often called a “silent infection” because many people experience no symptoms or only mild ones. This often leads to the infection going unnoticed, raising questions about whether its symptoms can appear and disappear.
Common Manifestations of Chlamydia
When symptoms occur, they vary depending on the affected area and the individual. For individuals with a vagina, symptoms may include abnormal vaginal discharge, bleeding between periods or after sex, and a burning sensation during urination. Lower abdominal pain or discomfort during sexual intercourse can also occur. For individuals with a penis, common signs include discharge from the tip of the penis, pain or burning during urination, and pain or swelling in one or both testicles.
Beyond the genitals, chlamydia can infect other body parts involved in sexual contact. Rectal infections may lead to pain, discharge, or bleeding from the anus. In the throat, infections are often asymptomatic but can occasionally cause a sore throat. Eye infections, known as conjunctivitis, can result in redness, pain, and discharge.
Reasons for Symptom Variability
Chlamydia symptoms vary, often being absent or intermittent, which is a notable aspect of the infection. Between 50% and 70% of people with chlamydia experience no noticeable symptoms. When symptoms appear, they can take weeks or even months to develop after exposure. This delayed or absent presentation contributes to the infection’s unnoticed spread.
Several factors contribute to this variability. The initial site of infection plays a role, as some areas like the throat are less likely to produce obvious symptoms compared to genital sites. Bacterial load and an individual’s immune response also influence whether symptoms develop and their intensity. The bacteria can exist in the body for extended periods without causing significant irritation or a strong immune reaction.
Health Implications of Unrecognized Chlamydia
Undiagnosed and untreated chlamydia can lead to serious and lasting health problems. For individuals with a uterus, untreated chlamydia can cause pelvic inflammatory disease (PID) by ascending to the upper reproductive organs. PID can result in chronic pelvic pain, damage to the fallopian tubes, and an increased risk of infertility or life-threatening ectopic pregnancies. Approximately 10-15% of women with untreated chlamydia may develop PID.
For individuals with testicles, untreated chlamydia can lead to epididymitis, an inflammation of the coiled tube at the back of the testicles where sperm mature. This condition can cause pain, swelling, and in rare cases, infertility. Both men and women can also develop reactive arthritis, a joint inflammation triggered by the infection, though this is less common. If transmitted during childbirth, newborns can develop eye infections (conjunctivitis) or pneumonia, which can be severe if not treated.
Importance of Screening and Treatment
Given the potential for silent infection and serious complications, regular chlamydia screening is a primary measure. Sexually active women under 25 should be screened annually, as should older women at increased risk due to new or multiple partners. Pregnant women are also screened early in pregnancy, with retesting recommended in the third trimester for those at continued risk. While routine screening guidelines for men vary, testing is considered for sexually active young men in high-prevalence settings and for men who have sex with men.
Chlamydia is curable with antibiotics, typically a single dose of azithromycin or a seven-day course of doxycycline. Completing the full course of prescribed medication is important to ensure the infection is fully cleared. Individuals should abstain from sexual activity for at least seven days after starting treatment and until their partner(s) have also been treated. Retesting approximately three months after treatment is recommended for all treated individuals to detect potential reinfection, which is common.