The young woman confidently told the nurse that she certainly didn't need to have a test for chlamydia because she hadn't slept with anyone except her boyfriend during the last year:
"I know I am not at risk, because he has been faithful to me. And I don't have any symptoms. Plus, he got tested for everything just before we got together and he didn't have any infections."
Famous last words.
Fortunately, the nurse in the Women's Health Department at University Health Services convinced her to have the test for this sexually transmitted infection (STI). The result? The young woman did have chlamydia. Her shocked response was "How can this be?" Well, it is possible because women can be infected with chlamydia for long periods of time, even years, without showing any symptoms.
For women, chlamydia is known as the "Silent STI." That's why it is critical for women who are sexually active to be tested regularly.
Basics of chlamydia
The chlamydia bacteria is transmitted by contact of mucous membranes (cervix, urethra, anus) with an infected person's fluids from the infected site (semen and mucous).
Transmission is most common with exposure through vaginal and anal sex.
Typically, chlamydia only affects the genital area. However, in infants chlamydia may be transmitted at the time of birth from an infected mother and can cause pneumonia and conjunctivitis (eye infection). Four million new cases are diagnosed every year.
Many of these cases are college students. An estimated one in 10 college- age women and men has chlamydia but exhibits no symptoms.
Women and chlamydia
Most often chlamydia infects the cervix in women. And although symptoms may not show up for a long time, if ever, when they do appear they may include:
heavier than normal vaginal discharge or change in color of discharge
vague discomfort such as pressure or burning during urination
bleeding between periods
pain or bleeding with intercourse
vague, lower abdominal pain
For women, chlamydia testing is painless and is done during a gynecological exam. A sample of cells is taken from the cervix or rectum (depending on sexual history) with a cotton swab and is sent to the lab for testing.
Although urine testing for chlamydia in women is available at some facilities, it is not as accurate as the test involving direct swabbing of the cervix. Routine screening for chlamydia during their annual pap smear appointment is highly recommended for women who have vaginal or rectal intercourse with male partners.
If a silent chlamydia infection goes untreated, it has the potential to cause inflammation and scarring in a woman's fallopian tubes, thereby leaving her infertile or at risk for a tubal pregnancy.
Men and chlamydia
Chlamydia symptoms in men usually appear earlier than in women. Chlamydia usually infects a man's urethra (urinary tube), and symptoms include:
penile discharge
burning during urination
increased frequency of urination
pain in the testicles
The most common test for chlamydia in men is collecting a urine sample. Another method involves swabbing a few millimeters inside the urethra or rectum for a sample of cells. False negative results are possible, especially in men with no symptoms.
How can you avoid chlamydia?
Abstinence is the best way to avoid catching chlamydia or any other STI. By abstaining from sexual activity altogether, you virtually eliminate your chances of being infected with an STI.
Consistently use condoms. Every time you have vaginal, anal or oral intercourse, wear a condom from start to finish. Condoms provide significant protection from chlamydia and many, although not all, STIs. And you're not restricted to male condoms. The female condom now provides an alternative when the male condom is not an option. During mouth-to-genital or mouth-to-anal contact, you can use a latex barrier (sometimes called a dental dam) for protection against STIs. Use a spermicide during vaginal sex. A spermicide containing non-oxynol 9, when used with a condom, may increase protection against chlamydia. Also, limit your number of lifetime sexual partners.
How is chlamydia treated?
If you do have chlamydia, the infection is curable with oral antibiotics if you take them correctly and for the duration of time ordered.
After you've completed treatment, your clinician may advise you to come back for a repeat chlamydia test.
Once treated, chlamydia can only recur if you're reinfected. Since there is always a risk of reinfection, all of your sexual partners should be treated as well, and you should avoid any sexual contact until all your sexual partners have completed treatment.
If after reading this you think you may be at risk for chlamydia, call University Health Services to either talk with an advice nurse or make an appointment to be tested.
Call 863-2633 for the women's health department, and 863-0774 for the general medicine department.
