Sexual contact carries the risk of contracting a number of sexually transmitted diseases or STDs. Despite the continuing education, media coverage, medical advice and advertising, people continue to have unprotected sex.
In the UK, according to government-published statistics, of 440,000 total reported cases of STDs cases in 2014, 206,774 were diagnosed as chlamydia. In the US, chlamydia is the most common bacterial infection that can be passed during sexual contact, with close to 3 million cases estimated every year.
The high number of cases is owing to the fact that many people with the infection do not experience symptoms, and therefore pass it on unknowingly. As a result, it is sometimes known as the “silent infection”. It is far more common than other sexually transmitted diseases like gonorrhoea or syphilis.
Chlamydia is caused by the bacteria Chlamydia trachomatis. Any form of sexual contact, whether anal, vaginal or oral, can spread the infection. Symptoms of chlamydia, when they appear, often occur fairly soon after transmission, perhaps as early as 5 to 10 days, but may occur several weeks later.
If you experience any of the symptoms mentioned later, you should consult a healthcare provider, regardless of how long it is since you last had sex.
If you are having sex with multiple partners or changing partner frequently, you will obviously increase the risk of contracting the infection. A man does not need to ejaculate to pass on the infection. Rates of infection are higher among younger people, because they may frequently change partners, use condoms irregularly, or be unwilling to seek testing and treatment for STDs.
It is believed that as many as 5% of young women in the 14-19 age group who are sexually active may have chlamydia, and this could have serious implications for their future fertility. However, people from other age groups should not be complacent, and anyone who is sexually active should be careful.
It is important to be aware that you can contract chlamydia more than once; having been exposed to the infection in the past does not cause you to become immune. There is also a risk that a pregnant woman may pass on chlamydia while giving birth. The baby may be born prematurely, be underweight, contract pneumonia or get an eye infection. Pregnant women should be tested for the infection early on in their pregnancy.
Chlamydia is nearly always passed on by sexual contact, the greater risk being from vaginal or anal sex, although there is the possibility of transmission during oral sex and a small risk that it could be passed on by touching your eye.
Worryingly, many people with chlamydia are asymptomatic and show no obvious signs of infection. This means that many people are unaware that they are carrying chlamydia and risk passing it on to sexual partners. In fact, the vast majority of men (90%) do not experience symptoms, nor do between 75-95% of women. The only way of knowing whether or not you and your partner are infected is for you both to get tested and then maintain a monogamous relationship.
While condoms offer a good degree of protection, and should always be used to protect your sexual health, there is still a small risk of contracting an infection. In addition, if you do not use condoms in the correct manner, you will increase your risk of exposure.
Symptoms of Chlamydia in women may include:
Likewise, men may also experience no symptoms. When they do, these symptoms may include:
If you contract the infection during anal sex, you may have the following symptoms:
In the eyes, symptoms include:
There are various tests to detect if you have chlamydia. You may be given a urine or a swab test, or the doctor may be able to detect a visible discharge coming from the cervix. Alternatively, a swab may be taken from the urethra in men or the cervix for women.
Dr Felix offers a simple and discreet chlamydia test kit, which can be used in the privacy of your own home – follow easy instructions to collect a sample and mail it back to our lab using the free return postage enclosed with your kit. The sample will be analysed at our NHS accredited laboratory and the results emailed to you within 3 days. Our lab uses the latest technology, and the most reliable test methodology called NAATs, or nucleic acid amplification tests, which give quick and accurate results.
The CDC recommends annual testing in women under the age of 25, or older women who are at a higher risk of infection. If you think you are infected, you should abstain from sex until you have seen a healthcare provider and been tested.
It would also be wise when embarking on a new relationship for both partners to be tested for chlamydia and other STDs so that if one of you has the infection you can be treated before you have sex. In addition, someone who has been treated for chlamydia should be tested again after 3 months.
Chlamydia treatment is simple and effective. You will need to take antibiotics, either in a single dose or a 7-day course. As always with antibiotics, be sure to complete the course; if you stop taking them because your symptoms have cleared up, you may not be cured of the infection.
Typical antibiotics prescribed to treat chlamydia are Azithromycin or Doxycycline 100mg capsules. The Azithromycin tablets can be prescribed as Azithromycin 250mg 4 tablets or Azithromycin 500mg 2 tablets, both have the same result. Avoid sex for 7 days after a single-dose treatment, or during a 7-day course. You should also warn anyone that you have recently had sexual contact with so that they can also be tested and treated if necessary.
In fact, doctors advise that anyone who has multiple partners should have regular tests for chlamydia, whether or not they have symptoms, because of the increased risk of transmission.
Failing to have chlamydia treated could have serious implications for female fertility. The infection may reach your uterus and fallopian tubes, and lead you to develop Pelvic Inflammatory Disease.
The risk of developing PID is between 20-30% among women who do not seek treatment. Like chlamydia itself, PID can be free of symptoms, although you may experience pain in the pelvis or abdomen. However, there is a danger that damage may have been caused while a woman is unaware that she has the infection.
The scarring that is sometimes caused by PID can cause a woman to have problems conceiving or to have an ectopic pregnancy, which is when the embryo implants outside the uterus. The pregnancy will be unviable and will have to be terminated; otherwise, the woman’s life can be at risk.
While chlamydia does not have the same implications for male fertility, a man with the infection still poses a risk to that of his female partner if he passes on the infection to her. He may also develop epididymitis, an inflammation of the tubes that carry sperm, or nongonococcal urethritis, an infection of the urethra.
Both men and women should also be aware that an untreated case of chlamydia can increase the risk of contracting HIV or transmitting it to a partner.
The best way to avoid getting chlamydia is to abstain from any sexual contact, including oral sex. If you do have any form of sexual contact, using a condom is the best way to prevent infection, although as with any form of birth control it cannot provide 100% protection.
However, condoms are the only form of birth control that protects against sexually transmitted diseases. It’s essential to take care to put on the condom correctly, and never use it more than once. If it slips off during sex, never put it back on; always use a new one. Also never use one that is out of date, or that looks as if it has been damaged.
Be very careful when opening the packet not to tear the condom with your fingernails, and apply equal care when placing the condom on the penis. Check that you are putting it on the right way, and pinch the tip between your finger and thumb so that air doesn’t get trapped inside (if it does, the condom can break). After sex, the man should hold the condom on as he withdraws so that it does not slip off. You should also protect yourself with a condom when having anal or oral sex, not just vaginal sex, and if you switch between one form of sex and another you should use a fresh condom to avoid the risk of transference. You can also use a dental dam during oral sex to protect yourself.
If you are sexually active, a long-term monogamous relationship with a partner who has tested clear for the infection is your best chance of staying free of it. As well as preventing yourself from contracting the infection, it is also important to avoid infecting others if you do have it.
Wait until your course of chlamydia treatment is complete before having sex again. Also, if your partner has passed it on to you, they should also be treated, or you risk being infected again.