Chlamydia is a highly prevalent bacterial sexually transmitted infection (STI) caused by the organism Chlamydia trachomatis. It is the most frequently reported bacterial STI in the United States. The bacterium spreads through various forms of sexual contact, including vaginal, oral, and anal intercourse. Understanding how this infection manifests is important for timely diagnosis and treatment, as it can have serious health consequences if ignored.
The Symptom Paradox: Often Invisible
The most defining characteristic of Chlamydia in men is the absence of noticeable physical signs. Approximately 50% of men who contract the infection are entirely asymptomatic, meaning they experience no symptoms. This lack of symptoms allows an individual to be infected and unknowingly transmit the bacterium to sexual partners. The infection can persist in the body for months or even years without causing visible changes.
Because the infection frequently remains hidden, relying on visual confirmation is unreliable. The deceptive nature of Chlamydia means that feeling healthy is not a guarantee of being infection-free. When symptoms appear, they typically develop one to three weeks after exposure, though this timeframe is highly variable. Routine screening remains the only reliable method for detection in the absence of outward signs.
Visible Signs of Chlamydia
When Chlamydia causes visible changes, these signs are typically related to inflammation of the urethra, known as urethritis. The most common visible symptom is a penile discharge that exits from the tip of the urethra. This discharge is often clear, watery, or mucus-like, but it can also appear cloudy, white, or yellowish. The volume is usually small, sometimes just a single drop noticed early in the morning.
Other noticeable symptoms involve discomfort during urination, medically termed dysuria. This is felt as a burning or painful sensation when urine passes through the inflamed urethra. The opening of the urethra may also become irritated, leading to localized redness, swelling, or an itching sensation. In some cases, the infection can spread, causing pain or swelling in one or both testicles.
Health Consequences of Delaying Treatment
Allowing a Chlamydia infection to go untreated can lead to serious complications within the male reproductive system. The infection can travel beyond the urethra, primarily targeting the epididymis, the coiled tube located at the back of the testicle. This complication, known as epididymitis, causes the tube to become inflamed and painful. Symptoms include sudden or gradual pain, swelling, and tenderness in the testicle and scrotum.
Untreated epididymitis can lead to long-term issues such as chronic pain or reduced fertility due to potential damage to the reproductive tract. Another serious complication is reactive arthritis, previously called Reiter’s Syndrome. This condition is joint inflammation that causes pain and swelling, typically affecting the knees and ankles, and may also involve inflammation of the eyes. Treating the underlying infection is the only way to prevent these damaging outcomes.
Confirming the Diagnosis and Treatment
Diagnosis of Chlamydia requires specific laboratory testing, since visible symptoms are unreliable or absent. The most common method involves collecting a urine sample for a nucleic acid amplification test (NAAT), which detects the bacterium’s genetic material. Alternatively, a healthcare provider may collect a swab sample from the urethra if discharge is present. Both methods offer accurate detection, even in asymptomatic cases, making regular screening recommended for sexually active individuals.
Once diagnosed, Chlamydia is a curable infection treated with oral antibiotics. The preferred regimen often involves a seven-day course of doxycycline, taken twice daily. Another common option is a single dose of azithromycin, although doxycycline is more effective for certain infection sites, particularly rectal infections. Patients must complete the full course of medication as prescribed, even if symptoms disappear quickly. Treatment must include notifying and treating all recent sexual partners to prevent reinfection and spread. Patients must abstain from sexual activity until both they and their partners have finished the treatment regimen.