Chlamydia in Women

What is chlamydia?

Chlamydia is an infection caused by a bacterium (germ) called Chlamydia trachomatis. In women, chlamydial infection usually affects the cervix and uterus (the womb). In men, it usually affects the urethra in the penis. (A separate leaflet called 'Non Gonococcal Urethritis' deals with chlamydial infection in men.) Chlamydia sometimes causes infection of the eye, throat, and lungs.

How do you get chlamydia and how common is it?

Most people with chlamydia got the infection by having sex with an infected person. About 1 in 20 sexually active women in the UK are infected with chlamydia. It is most common in women under 25. (About 1 in 12 women aged 20 are infected with chlamydia.) The number of cases has risen sharply in recent years. Many women are not aware that they are infected as it often causes no symptoms. You can be infected with chlamydia for months, even years, without realising it.

The risk of infection increases with the number of changes of sexual partner. Wearing a condom during sex helps to prevent chlamydia and other sexually transmitted infections.

What are the common symptoms of chlamydia?

No symptoms occur in up to 8 in 10 cases. If symptoms do occur, they can include:

• Vaginal discharge. This is due to the cervix becoming inflamed.
• Pain or burning when you pass urine.
• Bleeding or spotting between periods. In particular, bleeding after you have sex.
• Pain or discomfort in the lower abdomen (pelvic area), especially when you have sex.

Why should I have treatment if I have no symptoms?

• Because the infection may spread and cause serious complications (see below). This can be months or years after you are first infected.
• You can pass on the infection to your sexual partner(s) even if you do not have symptoms.

Do I need any tests?

Chlamydia can be confirmed by a 'swab' taken from the cervix and urethra. (A swab is a small ball of cotton wool on the end of a stick which is used to obtain mucus and cells to send to the lab for testing.) Newer tests using a urine sample or a swab from the lower vagina are becoming increasingly used. You may also be advised to be tested for other sexually transmitted infections.

What is the treatment for chlamydia?

A short course of an antibiotic usually clears chlamydial infection. Even if you have no symptoms, treatment is strongly advised to prevent possible complications. Tell your doctor if you are (or may be) pregnant. This may affect the choice of antibiotic. Do not have sex until you and your sexual partner have finished treatment (or for seven days after treatment with a 'single dose' antibiotic which is sometimes used).

Does my partner need to be treated?

Yes. Also, any other sexual partners within the past six months should also be tested for infection. (If you have not had sex within the last six months then your latest sexual partner should be tested and treated, however long ago the relationship was.) A course of an antibiotic is usually advised whether or not infection is found on testing. This is because:

• Chlamydial infection is commonly passed on during sex.
• Men and women often have no symptoms with chlamydia, but can still pass on the infection.
• The test for chlamydia is not 100% reliable. Treatment makes sure that any possible infection which may have been missed by the tests is cleared.
• If your sexual partner is infected and not treated, chlamydia can be passed back to you again after you are treated.

What are the possible complications of chlamydia?

• If left untreated, the infection may seriously affect the uterus and fallopian tubes (called 'pelvic inflammatory disease' or PID). About 1 in 5 women with chlamydia develop PID. This may develop suddenly and cause fever and pain. It can also develop slowly over months or years without causing symptoms (also known as 'silent PID'). However, over time, scarring or damage to the fallopian tubes may occur and can cause:
  • Chronic (persistent) pain.
  • Difficulty becoming pregnant (infertility).
  • If you become pregnant, you have an increased risk of ectopic pregnancy (where the pregnancy develops in a fallopian tube and can cause serious life threatening problems). About 4 in 10 ectopic pregnancies are due to infection with chlamydia.
• The risk of developing some complications of pregnancy such as miscarriage, premature birth, and stillbirth are increased in pregnant women with untreated chlamydia.
• If you have untreated chlamydia during childbirth, your baby may develop a chlamydial infection of their eye or lung during the birth.
• Reiter's syndrome is a rare complication. This causes arthritis and eye inflammation. It may be due to the immune system 'over-reacting' to chlamydial infection in some cases.

The risk of complications is much reduced if chlamydial infection is treated early.

Further help and information

If you suspect that you have chlamydia, or any other a sexually transmitted infection, then see your GP or contact your local Genito-Urinary Medicine (GUM) clinic. You can go to the local GUM clinic without a referral from your GP. You can ring the local hospital or health authority and ask where the nearest clinic is. It may also be listed in the phone book under 'Genito-Urinary Medicine'. Other resources include:

fpa
Helpline: 0845 122 8690 Web: www.fpa.org.uk
Provides information and advice on all aspects of contraception and sexual health.

British Association for Sexual Health and HIV (BASHH)
www.bashh.org
A professional association but their website includes contact details of GUM clinics.

Chlamydiae.com
www.chlamydiae.com
The comprehensive reference and education site for Chlamydia and the chlamydiae. By the University of Southampton.

Department of Health - information about chlamydia
www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Chlamydia/fs/en
Includes information about the national screening programme to detect young people with chlamydia who do not have symptoms.