Chlamydia

Chlamydia is a common sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis. It often goes unnoticed because many people do not experience symptoms. However, if left untreated, it can lead to severe complications such as infertility, pelvic inflammatory disease, and chronic pelvic pain.

Despite being easily treatable with antibiotics, chlamydia remains a significant public health concern due to its silent nature and high transmission rate. Raising awareness, encouraging regular screenings, and practising safe sex are crucial steps to controlling its spread.

Chlamydia is a bacterial infection primarily transmitted through sexual contact, including vaginal, anal, or oral sex. It can infect both men and women, affecting the genitals, rectum, and throat. Pregnant women can also pass the infection to their babies during childbirth.

Since the infection often presents without symptoms, it can easily go undetected, making routine screening essential for sexually active individuals.

Chlamydia is the most commonly reported bacterial STI globally. According to the World Health Organization (WHO), there were an estimated 129 million new cases of chlamydia worldwide in 2020.

In India, the actual prevalence is under-reported due to limited screening and social stigma. However, studies suggest that chlamydia is one of the top STIs in urban and rural populations alike, particularly among adolescents and young adults.

Chlamydia infections can occur in different parts of the body:

1. Genital Chlamydia: Most common; affects the cervix in women and the urethra in men.
2. Rectal Chlamydia: Acquired through anal sex; can affect both sexes.
3. Throat (Pharyngeal) Chlamydia: Acquired through oral sex; usually asymptomatic.
4. Ocular Chlamydia (Trachoma): A different strain of Chlamydia trachomatis causes eye infections leading to blindness, common in low-income regions.
5. Neonatal Chlamydia: Passed from mother to baby during delivery, leading to eye infections or pneumonia in newborns.

Chlamydia is caused by the bacterium Chlamydia trachomatis. It spreads through:

• Unprotected vaginal, anal, or oral sex
• Sharing sex toys without cleaning or using protection
• From mother to baby during childbirth
• Rarely, through direct contact with infected bodily fluids

Risk increases with:

• Multiple sexual partners
• Inconsistent condom use
• Previous or concurrent STIs

Chlamydia is often called a “silent” infection because up to 70% of infected women and 50% of men show no symptoms.

In Women:

• Abnormal vaginal discharge
• Burning sensation during urination
• Lower abdominal or pelvic pain
• Pain during sex
• Bleeding between periods or after sex

In Men:

• Penile discharge
• Pain or burning during urination
• Swollen or tender testicles
• Rectal pain or discharge (if rectally infected)

Testing is the only way to confirm chlamydia. Diagnosis is straightforward and includes:

• Nucleic Acid Amplification Tests (NAATs): Most sensitive test using urine or swab samples
• Urine Tests: Common for both men and women
• Swab Tests:
  
  • Vaginal swabs (self-collected or clinician-collected)
  • Cervical swabs
  • Rectal and throat swabs for specific sexual practices

Routine screening is advised for:

• Sexually active women under 25
• Pregnant women
• Men who have sex with men

Chlamydia is easily treatable with antibiotics. Common treatments include:

1. Azithromycin: Single-dose therapy. (Alizeth 500mg tablet)
2. Doxycycline: Seven-day course. (Doxylab 100mg Capsule)

In some cases, alternative antibiotics like erythromycin or levofloxacin may be used.

Important treatment considerations:

• Complete the full course of antibiotics
• Avoid sexual activity until at least 7 days after treatment
• Get retested after 3 months
• Notify sexual partners for testing and treatment

There is no alternative therapy proven to cure chlamydia. However, some complementary approaches may help relieve symptoms:

• Probiotics: May help restore natural flora during antibiotic treatment
• Warm compresses: To relieve pain and inflammation
• Herbal supplements: E.g. garlic or goldenseal (not a substitute for antibiotics)

Always consult your doctor before using any non-medical remedies.

Risk factors for acquiring chlamydia include:

• Age under 25 years
• Multiple sexual partners
• Unprotected sex
• Previous STI history
• Lack of regular STI screening
• Living in areas with high STI rates

If untreated, chlamydia can lead to serious health issues:

In Women:

• Pelvic inflammatory disease (PID)
• Infertility due to fallopian tube damage
• Ectopic pregnancy
• Chronic pelvic pain

In Men:

• Epididymitis (inflammation of the testicles)
• Reduced fertility

In Newborns:

• Conjunctivitis (eye infection)
• Pneumonia

Chlamydia also increases the risk of HIV transmission.

• Follow your treatment plan exactly
• Refrain from sexual activity until cleared by your doctor
• Inform current and past sexual partners
• Get retested 3 months post-treatment
• Maintain open communication with your partner(s)
• Make STI screening a regular part of healthcare

Myth 1: Only promiscuous people get chlamydia
 Truth: Anyone who is sexually active can get chlamydia, regardless of lifestyle.

Myth 2: You can’t get chlamydia from oral sex
 Truth: Oral sex can transmit the infection to the throat.

Myth 3: Antibiotics always prevent complications
 Truth: Delayed treatment increases the risk of complications.

• If you have symptoms like unusual discharge, pain during urination, or pelvic pain
• After unprotected sex with a new partner
• If your partner has tested positive for chlamydia or another STI
• During routine sexual health check-ups

Early diagnosis and treatment can prevent complications.

• What test will confirm chlamydia?
• How long after exposure should I get tested?
• What are the treatment options?
• Should my partner also get tested?
• Can I get re-infected?
• What precautions should I take to avoid future infections?
• When is it safe to resume sexual activity?

• Listen without judgment
• Offer to accompany them to doctor visits
• Encourage them to complete treatment
• Support regular testing and safe sex practices
• Reassure them that chlamydia is common and treatable

Chlamydia is a widespread but manageable STI that often presents without symptoms. Awareness, early detection, and complete treatment are vital to avoiding complications and halting transmission. Through safe sex practices, regular screenings, and education, individuals can significantly reduce their risk.

Addressing the social stigma associated with STIs is also crucial. By normalising sexual health discussions and encouraging responsible behaviour, we can take a step toward better public health outcomes.