Chlamydia: signs, symptoms and complications

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The signs and symptoms of chlamydia infection depend on the infected part of the body, be it the vagina, penis, rectum, or throat. They can range from vaginal or penile discharge to severe abdominal or pelvic pain. Discomfort often occurs during sexual intercourse or while urinating. But all too often, warning signs are missing.

Because chlamydia can cause damage and other complications even without symptoms, regular screening tests are essential to make sure the infection is detected and treated early to avoid these problems.

© Get Information on Medicines, 2018

Frequent symptoms

Most people with chlamydia feel fine. About 70% of women and 93% of men have no symptoms associated with the infection. However, the absence of symptoms does not mean that there is no infection or that it is not a problem.

Chlamydia symptoms usually appear about three weeks after infection. In some cases, the infection can persist for months or years before being finally detected. During this time, other couples can become infected.

Symptoms of chlamydia complications can appear much later after infection.

Some of the possibilities include:

  • Vaginal / penile discharge: The most common symptom of chlamydia in women is vaginal discharge . It is usually yellowish in color, but both the consistency and the color can vary. Men can have a discharge from the penis that is often clear and thin, but can also be thick and slimy.
  • Painful urination: Both men and women may experience painful urination ( dysuria ) due to inflammation of the urethra (urethritis), the tube that leads from the bladder to the outside of the body. You may also need to urinate more often.
  • Pain, swelling, or itching in the penis or vulva: Redness, pain, swelling, or itching may occur around the opening of the penis in men or on the vulva (the outer part of the genitals) or vagina in women.
  • Pain During Intercourse / Painful Ejaculation: The cervix is the site of infection in most cases of chlamydia in women. This can cause discomfort during sexual intercourse ( dyspareunia ), especially with deep penetration. Pain can also occur due to pelvic inflammatory disease (PID) or inflammation of the fallopian tubes. Men can experience pain when ejaculating.
  • Bleeding between periods or during sexual intercourse: This may be due to inflammation of the cervix associated with chlamydia.
  • Abdominal and pelvic pain : Pain in the abdomen, pelvis, and back can occur with pelvic inflammatory disease.
  • Pain or swelling of the testicles: Pain and swelling of the testicles can occur when chlamydia in men travels up through the urethra into the epididymis , the tube at the back of the testicle. Inflammation ( epididymitis ) can occur.
  • Rectal pain, discharge, or bleeding: These can occur when the rectum is infected with chlamydia due to transmission of the infection during susceptible anal sex.

Rare symptoms

Less common symptoms include:

  • Sore throat: Transmission of bacteria during oral sex can cause a sore throat, pus on the tonsils, and pain when swallowing.
  • Pain in the upper right corner of the abdomen ( perihepatitis ): This is a condition in which the liver capsule becomes inflamed. Also known as Fitz-Hugh-Curtis syndrome, it causes pain in the upper right part of the abdomen.
  • Joint pain (reactive arthritis): There may be symptoms of inflammation in only a few joints (oligoarthritis) in combination with inflammation of the eyes and urethra. This reactive arthritis is not caused by an infection. Instead, it's due to a post-inflammatory process in which the body produces infection-fighting proteins that mistakenly target its own tissues. This most often occurs one to four weeks after contact with the bacteria and disappears after three to 12 months. It may or may not improve with antibiotics.

Complications

Complications from chlamydia infection can be serious. These problems can affect you whether or not you have experienced chlamydia symptoms. These complications can be largely prevented with regular examination and prompt treatment .

Pelvic inflammatory disease (PID)

Chlamydia can cause abdominal and / or pelvic pain in women when bacteria travel through the cervix and uterus to the fallopian tubes and ovaries, causing PID.

About 10% to 15% of women with untreated chlamydia will develop PID, which causes symptoms (acute) or shows few or no symptoms (symptomatic).

Symptoms of PID can also include abdominal and pelvic pain, throbbing back pain, and sometimes fever or chills.

On examination, a woman may experience discomfort during a pelvic exam.

Chronic pelvic pain

Pelvic inflammatory disease can lead to chronic pelvic pain . It is common in about 30% of women who have had PID due to chlamydia.

Feminine infertility

With PID, infection and inflammation can lead to scarring of the fallopian tubes. This scarring can block the passage of sperm into the fallopian tubes, interfering with fertilization and leading to infertility .

Ectopic pregnancy

An ectopic pregnancy or tubal pregnancy is a condition in which a fertilized egg implants in the fallopian tubes instead of in the uterus. This can happen if the fallopian tubes are cut from the EPI.

An ectopic pregnancy can be life-threatening, especially if it ruptures before it is discovered.

About 20% of women who develop PID are infertile . Although surgery can be used to remove scars on the fallopian tubes, it can increase the risk of an ectopic pregnancy.

Male infertility

It is not known for sure whether chlamydial epididymitis leads to male infertility. This can lead to chronic pain in the pelvis or scrotum.

Complications of pregnancy

Women who have   Untreated chlamydia during pregnancy has an increased risk of various complications during pregnancy. Therefore, all pregnant women are advised to have a chlamydia test at their first visit to the obstetrician.

There is an increased risk of preterm delivery and complications that accompany preterm delivery. Also, after delivery, the risk of endometritis or uterine inflammation increases.

Babies born to mothers who are not treated for chlamydia are more likely to be small for gestational age or low birth weight.

The risk of stillbirth is approximately 40% higher in pregnant women with untreated chlamydia compared to women without chlamydia. Fortunately, treatment before and during pregnancy practically eliminates the risk.

Complications of newborns

If a pregnant mother does not treat chlamydia, the baby can become infected during labor through the vaginal birth canal. Two problems can arise:

  • Eye infections Conjunctivitis (neonatal ophthalmia) is believed to occur in almost 40% of babies born to mothers with untreated chlamydia. Symptoms such as puffy eyelids, red eyes, and thick, yellowish discharge usually appear in the first 10 days of life.
  • Pneumonia – somewhat less common and occurs in 3-16% of babies born to mothers with untreated chlamydia. Pneumonia most often occurs 4 to 12 weeks after delivery and usually begins with a cough and a stuffy nose.

It is important to note that if a mother is treated for chlamydia before or during pregnancy, the baby must be safe from these infections. For people at high risk, some obstetricians recommend retesting for chlamydia during the third trimester.

Scars and fissures of the rectum.

In rare cases, inflammation of the rectum (proctitis) can lead to scarring, cracking, or abnormal ducts from the rectum to another area or outside the body.

Cervical cancer risk

There is controversy as to whether chlamydial infections can increase the risk of cervical cancer from the human papillomavirus (HPV) .

A 2016 review of 22 studies concluded that HPV and chlamydia coinfection doubles the risk of cervical cancer. In 11 studies, chlamydia was an independent predictor of cervical malignancy.

Pelvic inflammation associated with chlamydia is believed to exacerbate the cancerous changes caused by HPV. However, it is important to note that, in general, HPV infection, not chlamydia, is the main culprit for the development of cervical cancer.

HIV risk

Chlamydia infections (as well as other sexually transmitted infections, STIs) can also increase the risk of contracting or transmitting HIV .

There are two reasons for this:

First, the infection can cause inflammation of the genitals, which can compromise the integrity of the lining of the vagina, cervix, urethra, and rectum. This gives HIV a more direct route to the bloodstream and lymphatic system.

Second, active chlamydia infection can increase HIV viral activity around the genitalia. When this happens, the person may have an undetectable viral load in blood tests, but a detectable viral load in semen or vaginal secretions.

Some studies have shown that chlamydia infections were seen in 15% of men who have sex with men (MSM) newly infected with HIV.

Lymphogranuloma venereum

Unlike the more common subtypes of Chlamydia trachomatis that cause infections, there are some (L1, L2, and L3) that can cause a more severe syndrome known as lymphogranuloma venereum (LGV).

It includes systemic symptoms and swollen lymph nodes, which can sometimes be mistaken for inflammation caused by other conditions, such as syphilis .

The course of treatment for LGV variations is significantly longer than for others.

Lymphogranuloma venereum usually begins with a lump on the genitals one to two weeks after infection, progressing to an open sore. Swollen lymph nodes and flu symptoms appear after about two to six weeks.

Symptoms include :

  • Enlarged and painful lymph nodes in the groin (groin nodes)
  • Fever and chills
  • An open sore on the genitals (genital ulcer) where bacteria have entered the body.
  • Muscle pain

Complications can occur many years later due to damage to the lymphatic system in the groin.

Trachoma

As the leading cause of blindness worldwide, trachoma is not an STI, but rather an infection spread through discharge from the eyes or nose. This usually begins with redness and a condition where the eyelashes curl inward and scratch the cornea.

Trachoma is caused by different types of Chlamydia trachomatis than genital infections.

Any eye symptoms in third world countries must be carefully evaluated, as prompt treatment is needed to preserve vision.

When to contact a healthcare provider

It is important to talk to your doctor if you have any signs or symptoms of chlamydia, any other symptoms that bother you, or if you know or think you have been exposed.

According to the US Preventive Services Task Force , women age 25 and younger and those who are sexually active should be screened for chlamydia annually, as do older women who are at increased risk of infection .

Screening for other STIs / STDs is also important, as risk factors for chlamydia also increase your chance of getting these other infections. If you are being treated for chlamydia, be sure to tell your doctor if any of the symptoms persist.

Get the word of drug information

It can be difficult to read about the possible complications of chlamydia, but many of them can be prevented with the proper tests, talking to your healthcare provider about any symptoms, and receiving treatment if the result is positive. Our discussion guide for doctors below can help you start a conversation with a healthcare professional.

Chlamydia Doctor Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.

Frequently asked questions

  • The most common symptoms of chlamydia in men include:

    • The discharge from the penis can vary from clear and fine to mucous and thick.
    • Painful urination (dysuria)
    • Frequent urination
    • Pain, swelling, redness, itching, and pain around the opening of the penis.
    • Pain with ejaculation.
    • Pain in the abdomen and pelvis.
    • Swelling or pain in the testicles.
    • Rectal pain, discharge, or bleeding

  • The most common symptoms of chlamydia in women include:

    • Vaginal discharge is usually yellow
    • Painful urination (dysuria)
    • Frequent urination
    • Pain, swelling, redness, itching, and pain around the vulva or vagina
    • Pain during intercourse
    • Bleeding between periods or during intercourse.
    • Pain in the abdomen and pelvis.
    • Rectal pain, discharge, or bleeding

  • Yes. For most people (about 70% of women and 93% of men), there are no symptoms associated with chlamydia infection. However, the infection can cause significant damage and complications. It can also be passed on to other people, so regular reviews are essential.

  • Symptoms can appear up to three weeks after first contact. But in many cases, the infection can go undetected for months or even years, as symptoms may not develop until complications begin.

  • Chlamydia is spread by contact with bodily fluids such as semen or cervical mucus. It is unlikely to be transmitted only through skin-to-skin contact, but through bodily secretions. Condoms can be very effective in preventing the spread of chlamydia.

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