Chlamydia

It’s caused by bacteria called Chlamydia trachomatis, which in infected people is usually found in the vulva/vagina/front hole, cervix and the urethra (the tube where urine/pee comes out). It can also be found in the rectum (back passage) and the throat. 

Anyone who is sexually active can get chlamydia and pass it on, even if you don’t have lots of sexual partners. 

Symptoms may show within one to three weeks after coming into contact with chlamydia, many months later, or not until infection spreads to other parts of the body. Most people have no noticeable signs or symptoms of infection. 

If you do notice symptoms they can include the following:

If you have a penis it can cause: 

• a whitish, cloudy or watery discharge
• pain when urinating
• burning or itching in the urethra (the tube that carries urine out of the body)
• pain and swelling in the testicles.

If you have a vulva/vagina/front hole it can cause: 

• an unusual or changed discharge
• pain when urinating
• pain in the lower belly or back
• pain and/or bleeding during or after sex
• bleeding between periods or heavier periods, including those using hormonal contraception. 

Infection in the rectum (back passage) generally causes no symptoms but might cause discomfort and discharge.

Infection in the throat is less common and is usually symptom free.

Infection in the eyes can cause pain, redness, swelling, irritation and/or discharge (conjunctivitis).

Chlamydia is usually passed from one person to another when having sex. You can be infected if you come into contact with the semen or vaginal/frontal fluids of someone who has chlamydia. 

Chlamydia is most commonly spread by: 

• vaginal/frontal, oral or anal sex without condoms
• sharing sex toys that are not washed or covered with a condom each time they are used with a different person
• your genitals  coming into contact with your partner’s genitals
• infected semen or vaginal/frontal fluid getting in your eye.

It's not yet known whether chlamydia is spread on fingers when you touch an infected part of the body, then touch other parts of your or someone else’s body.‍

Help protect yourself against most STIs such as chlamydia:

• Use internal or external condoms, which help prevent you coming into contact with bodily fluids containing the bacteria, every time you have vaginal/frontal or anal sex.
• Avoid sharing sex toys without using a new condom for each person. Wash sex toys well after you have used them. Some people use sterilising fluid that’s used to clean baby feeding bottles.
• It is also advised that if you want to be as sure as you can be of not getting chlamydia via oral sex that a condom is used to cover the penis, or a latex or plastic ‘dam’ is used to cover the vulva or anus.

Other types of contraception, such as the contraceptive pill, or HIV prevention tools such as PrEP (pre-exposure prophylaxis) offer no protection against STIs.

If a person with HIV is not taking HIV treatment (usually because they have not tested and do not know they have HIV), having untreated chlamydia may make them more infectious and liable to pass on HIV because untreated STIs can increase the amount of HIV present in semen and vaginal/frontal fluid.  

However, if the person with HIV is taking effective HIV treatment and has an undetectable viral load (the level of HIV in the body is so low that tests cannot detect it) they cannot pass on HIV. Chlamydia will not make a difference to this.

If an HIV negative person has a chlamydia infection, it is more likely that they could acquire HIV if they are exposed to the virus.  

It’s important not to delay going for a test if you think you might have chlamydia. A test will be carried out right away, and you may be advised to test again two weeks later. 

You are more likely to become infected with chlamydia if 

• you are under 25, 
• you have a new sexual partner
• you have had more than one sexual partner in the last year
• you haven’t used internal or external condoms. 

Where can I get tested for chlamydia?

‍There are a number of services that do chlamydia testing, so choose the one you feel most comfortable with. 

Most people get tested and treated for infections like chlamydia at sexual health or GUM (genitourinary medicine) clinics. It's free and confidential, so no one else, including your GP, will be told about your visit. 

GP surgeries, contraception clinics, young persons clinics and some pharmacies also test for and treat these infections.

Chlamydia tests are simple and painless.

A sample of cells can be collected for testing in two ways:

• giving a sample of urine (you will be advised not to pee for one to two hours before the sample is taken)
• gently wiping a swab (small cotton bud) over the area that might be infected. If you have oral and/or anal sex make sure that swabs are taken from those areas as well as the vulva/vagina/front hole or penis.

Swabs only take a few seconds and don’t hurt – they may be slightly uncomfortable for a moment or two. A doctor or nurse may take the sample, or you can ask to do the swabs yourself. A swab looks a bit like a smaller more rounded cotton bud, although sometimes it has a plastic loop rather than a cotton tip. 

You can also get chlamydia testing kits to do at home, either buying your own from a pharmacy, or for free if you are 25 or under. The NHS website has a tool to help you check if free tests for young people are available in your area.

Chlamydia is treated with antibiotics. The most common treatments are:

• a single dose of azithromycin
• a week-long course of doxycycline.

You will notice an improvement in your symptoms quite quickly after having treatment. 

• Discharge and pain when you urinate should lessen within a week. 
• Bleeding between periods or heavier periods should lessen by your next period. 
• Pelvic pain and pain in the testicles should lessen quickly, although they may take up to two weeks to go away completely.

If you continue to have pelvic pain or painful sex that doesn’t improve, see your doctor or nurse as it may be necessary to have further treatment or investigate other possible causes of the pain. 

When can I have sex again?

Don’t have vaginal/frontal, oral or anal sex, or share sex toys, even with a condom, until you and your partner(s) have finished the treatment and the symptoms have gone as you could pass on the infection if you have sex before treatment has finished. To prevent re-infection or passing the infection on, wait 7 days after your treatment has finished to have sex.

Even if you are given a single dose of antibiotics, you need to wait 7 days to have sex with other people.

Letting your partner/s know

If your test shows that you have chlamydia it is important that people you have had sex with recently are also tested and treated as they may have the infection without knowing it.

You may be given a contact slip to send or give to your partner(s) or with your permission the clinic can contact them if you don’t want to. This will inform them that they may have been infected with an STI and suggest that they go for a check-up. This information may be sent by text rather than by a paper slip. The staff at the clinic can discuss with you which of your partners may need to be informed and tested. 

Whichever way the information is sent to your partner(s) it will not have your name on it or identify you in any way, so your confidentiality is protected. 

If you feel angry or upset that you have chlamydia and find it difficult to talk with a partner or friends about it, please don’t be afraid to discuss how you feel with the staff at the clinic or general practice (GPs). 

If chlamydia is not treated, it can spread to other parts of the body. The more times you have chlamydia the more likely you are to get complications from the infection.

If you have a vulva/vagina/front hole chlamydia can spread and cause PID (pelvic inflammatory disease) which may lead to long term pelvic pain, blocked fallopian tubes, infertility and ectopic pregnancy, where the pregnancy develops outside of the womb.

Anyone can get chlamydia and you can only be certain you have chlamydia if you have a test, so regular STI tests are a both a good idea and important for your sexual wellbeing. This is true for everyone although it’s especially the case if you are starting a new relationship, if you want to stop using condoms with your partner, if you have multiple partners or if you don’t use condoms consistently.

It’s best to test if:

• You or a sexual partner think either of you may have symptoms
• You’ve recently had sex without a condom with a new sexual partner
• You, or a partner, have had sex without a condom with other sexual partners
• During a vaginal/frontal exam, your doctor or nurse says that the cervix is inflamed and/or there is an unusual discharge
• A sexual partner tells you they have an STI
• You have another STI such as gonorrhoea

There is no reason to be embarrassed or guilty about getting an STI, in fact we know that these feelings actually stop people from getting tested and treated, making it more likely that STIs will impact on your sexual health and are passed on to your partners.

Terrence Higgins Trust can provide emotional support if you are worried about your sexual health or have concerns about living with HIV. We can help you access services local to you across the UK, whether provided by us or by someone else.

Call THT Direct on 0808 802 1221 for support, advice and information or email info@tht.org.uk

Visit tht.org.uk for the latest HIV and sexual health information.