Chlamydia is one of the most common sexually transmitted infections worldwide. But in most cases (around 80%), an infection causes no symptoms and goes undetected for a long time. Without early detection and treatment, a chlamydia infection can have far-reaching health consequences. For instance, it can cause scarring on female reproductive organs which may result in an ectopic pregnancy or infertility. Keep reading our factsheet to learn all about chlamydia, its impact on fertility, and treatment.
How common is chlamydia?
The World Health Organization estimates that in 2016 there were over 124 million chlamydia infections worldwide. So that means that about 38 of every 1,000 women and 33 of every 1,000 men were affected by a urogenital chlamydia infection. But the actual rates of chlamydia infections are much higher, because it usually doesn’t cause symptoms, there are no routine screenings for the disease, and infections aren’t subject to mandatory reporting.
The disease occurs most frequently in women and men between the ages of 14 and 19, followed by the age group 20 to 24.
Causes of chlamydia
Chlamydia bacteria is spread through unprotected vaginal, oral, and anal sex. Sharing sex toys with an infected person can lead to an infection too. It can also spread from a mother to her children during childbirth and can cause newborns to develop pneumonia or a serious eye infection.
Because chlamydia is sexually transmitted, the risk of catching it increases the more sexual partners a person has. With advancing age and in stable, partnered relationships, the infection rate decreases sharply.
Usually, chlamydia is asymptomatic so it’s often detected late or not at all. Sometimes the symptoms can be mild and get overlooked.
Signs of chlamydia can include:
- Discharge from the vagina or penis
- Itching and burning while peeing
- Pain and swelling in the pelvic area
- Pain, discharge or bleeding from the rectum
- Vaginal bleeding between periods and after sex
- Fever or fatigue
Without symptoms and subsequent treatment, the bacteria can multiply and lead to chronic inflammation of the genital organs.
There are two ways doctors screen for chlamydia: a urine test and a swab test. For women, a swab of discharge can be taken from the cervix during a routine Pap smear. And for men, a doctor can insert a slim swab inside the end of the penis for a sample from the urethra. There’s also been a growing number of home testing kits.
The samples are examined under a microscope to check for the presence of the bacterial infection.
If the result comes back positive, it’s important to immediately get in touch with your past sexual partners so that they can get tested too and receive treatment if necessary.
How chlamydia affects fertility
Chlamydia is a common cause of infertility, which is why early detection and treatment are so important. If you are struggling to conceive, make sure to get tested for chlamydia to find out if that’s the reason. When testing your fertility with LEVY Health, we will give you a personalized recommendation of all of the tests you need based on your answers to detailed health questions.
The Centers for Disease Control and Prevention in the U.S. estimates that about 10-15% of women with undetected chlamydia will develop pelvic inflammatory disease. That and a silent chlamydia infection in the upper genital tract can result in permanent damage to female reproductive organs, including the fallopian tubes, uterus, and surrounding tissue. This can make it more difficult to get and stay pregnant.
For instance, scarring and blockages in the fallopian tubes can prevent an egg from reaching the uterus, which may result in an ectopic pregnancy (a potentially life-threatening pregnancy where the baby grows inside the fallopian tube) or infertility. The uterine lining can also be affected by a chlamydia infection, increasing the risk for premature birth and miscarriage. In men, inflammation of the testicles or epididymis can harm sperm quality.
The only way to prevent permanent damage to the reproductive organs is to treat the infection while it’s still at an early stage.
Chlamydia is treated with antibiotics. After about 1-2 weeks of taking medication, the infection can go away. For some infections, treatment may take longer. Talk to your provider about any next steps to confirm that your infection is gone after you’re done with the medication.
Until the infection clears, be sure to avoid sexual contact so that you don’t spread the disease. Contact all of your partners so that they can get tested and treated if necessary.
Note that while antibiotics can get rid of the infection, they can’t reverse damage to the body already caused by the disease. That’s why it’s important to get tested regularly for chlamydia so it can be treated as soon as possible. Getting chlamydia once doesn’t make you immune from catching it again in the future.
If chlamydia has led to scarring in your fallopian tubes, surgery can help remove adhesions and improve your chances of having a successful pregnancy.
Chlamydia is a sexually transmitted bacterial infection that can have serious health consequences if untreated. But because it only sometimes causes symptoms, infections can go on a long time without being detected. Testing for chlamydia is a routine examination for people struggling to conceive because of its potential impact on the reproductive organs and fertility. For custom tips on how to improve your fertility, test your fertility with LEVY Health – our doctors are happy to assist you on your journey to parenthood.
STDs & Infertility. Centers for Disease Control and Prevention. Accessed 14 June 2022.
Chlamydia trachomatis. Mayo Clinic. Accessed 14 June 2022.
Chlamydia. Cleveland Clinic. Accessed 14 June 2022.
Bébéar C, de Barbeyrac B. Genital Chlamydia trachomatis infections. Clin Microbiol Infect 2009;15:4-10. doi:https://doi.org/10.1111/j.1469-0691.2008.02647.x.
Bundesverband der Frauenärzte: Chlamydieninfektionen – Sex-Risiko mit Spätfolgen. Available from URL: https://www.bvf.de/aktuelles/pressemitteilungen/meldung/news/chlamydieninfektionen- sex-risiko-mit-spaetfolgen/
Gemeinsamer Bundesausschuss: Screening auf genitale Chlamydia trachomatis-Infektionen bei Frauen. Abschlussbericht des Unterausschusses „Familienplanung“ des G-BA, 30. Januar 2008.
Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis. 2010;201(Suppl 2):S134-55. doi:10.1086/652395.
Hoenderboom BM, van Bergen J, Götz HM, Hoebe C, de Vries H, van den Broek I, et al. Pregnancies and Time to Pregnancy in Women With and Without a Previous Chlamydia trachomatis Infection. Sex Transm Dis 2020;47(11):739-747. doi:10.1097/OLQ.0000000000001247.
Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS One. 2015;10(12):e0143304. doi:10.1371/journal.pone.0143304.
Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates. Bull World Health Organ 2019;97:548-562P. doi:http://dx.doi.org/10.2471/BLT.18.228486
Tang W, Mao J, Li KT, Walker JS, Chou R, Fu,R, et al. Pregnancy and fertility-related adverse outcomes associated with Chlamydia trachomatis infection: a global systematic review and meta-analysis. Sex Tranm Infect 2020;96:322-329. doi:10.1136/sextrans-2019-053999.
WHO guidelines for the Treatment of Chlamydia trachomatis. Geneva: World Health Organization; 2016.
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