Chlamydia service

Chlamydia is a very common sexually transmitted infection caused by the bacterium ‘chlamydia trachomatis’. It can infect both men and women, though the symptoms will be slightly different. Many people have no visible symptoms at all, although it can still be harmful and spread to sexual partners.

Chlamydia infects the neck of the womb (cervix) and uterus in women. In men, it can infect the urethra. Chlamydia can also cause infection of the eyes, throat and rectum (bottom).

Most people get infected with chlamydia through vaginal, anal or oral sex.

How common is chlamydia?

Chlamydia is one of the most common sexually transmitted infections in the UK, especially in young adults. Recently, about 60% of reported chlamydia cases were found in young people under 25 years. In 2018, around 104,000 men and around 130,000 women were diagnosed with chlamydia.

The symptoms of chlamydia are slightly different in men and women.

Some common symptoms of chlamydia in men are:

• pain from the end part of your penis
• discharge from your penis or bottom
• burning pain when you pass urine
• painful or swollen testicles

Some common symptoms of chlamydia in women are:

• discharge from your vagina
• burning pain when passing urine
• pain or discomfort in your lower tummy after sex
• spotting or bleeding in between your usual monthly periods
• bleeding after having sex

About 7 in 10 men and 5 in 10 women infected with chlamydia may be asymptomatic (do not have any chlamydia symptoms). This makes it easier to pass on chlamydia to other sexual partners, as you might be unaware that you have the infection. This will mean you will not get treatment or take precautions against spread.

If you have had unprotected sex with someone who may have chlamydia, you should get tested for chlamydia as soon as possible.

No. Chlamydia does not usually go away without treatment, but some people can have chlamydia without noticeable symptoms for weeks or months.

What happens if chlamydia is left untreated?

If you have chlamydia and it is left untreated for a long time, it can cause serious complications.

In men, untreated chlamydia may cause:

• reduced fertility
• reactive arthritis (painful swollen joints)
• an infection (known as epididymo-orchitis) of the testicles and epididymis (tube carrying sperm from the testicles)

Complications of untreated chlamydia in women are:

• pelvic inflammatory disease which can cause pain, infertility and increase the risk of having ectopic pregnancies
• reactive arthritis (painful swollen joints)
• pregnancy complications like miscarriages, premature births and stillbirths

The treatment for chlamydia is a course of antibiotics. The most common antibiotics used to treat chlamydia are doxycycline (the first line treatment for most people) and azithromycin.

If you have an increased risk of complications from chlamydia, your doctor may prescribe a longer course of antibiotics.

You may also be prescribed different antibiotic options if you are pregnant, breastfeeding or have allergies to some antibiotics.

What is the best antibiotic for chlamydia?

Currently, the first line preferred antibiotic for treating chlamydia is doxycycline 100mg, which you should take twice daily for 7 days. Doxycycline is the most effective antibiotic treatment for chlamydia, and is 95% effective.

While doxycycline is the best option for most people, in some cases it may not be suitable. Doxycycline is not recommended if you are pregnant or breastfeeding, so you will need a different antibiotic.

Azithromycin is another treatment for chlamydia which used to be the first line but is no longer recommended as the preferred option. The guideline was changed in 2018 because azithromycin was not as effective in treating chlamydia which has spread to the rectum or anal area, but doxycycline was effective in such cases. In addition, the use of single dose azithromycin was causing antibiotic resistance of other sexually transmitted infections.

Is chlamydia treatment the same for men and women?

Yes, the treatment for chlamydia is usually the same for men and women. The exceptions are usually if you are pregnant, breastfeeding or allergic to certain antibiotics.

Chlamydia treatment works by stopping the bacteria that causes chlamydia from producing an important protein which it needs to multiply. This stops the bacteria from growing and replicating, so your symptoms should improve as your body is cleared of chlamydia.

The first line treatment for chlamydia in the UK is doxycycline. The usual dose is one tablet to be taken twice daily for 7 days. You can swallow doxycycline tablets whole with water and take them with or without food. You should sit up for about 30 minutes after each dose to prevent symptoms of throat irritation or stomach upset.

How effective is chlamydia treatment?

Antibiotics are very effective in treating chlamydia. About 95% of people being treated for chlamydia will be cured if they take the antibiotics correctly as prescribed.

How long does it take for chlamydia to go away after treatment?

Chlamydia infection usually clears after one week of completing your antibiotic treatment. During treatment, you should avoid drinking alcohol as this can reduce how effective the antibiotic is.

You should also avoid having sex (with or without condoms) during treatment as you could still pass on the infection to your partner. It is common for partners to pass chlamydia between one another if they continue to have sex without completing their treatment, causing repeated infections.

How long do chlamydia symptoms last after treatment?

Your chlamydia symptoms should improve after your antibiotics treatment course. If they do not improve, you may need to book for another chlamydia test in the first instance.

When can I have sex again after taking chlamydia treatment?

It takes 1 full week of treatment to be effective. You should avoid any sexual contact, both with or without a condom, for 7 days after starting treatment as you could still be contagious.

How do you know if chlamydia is gone after treatment?

Your chlamydia symptoms should improve within a week of completing your course of antibiotics.

You do not need an immediate follow-up test to check if your chlamydia treatment has worked, as dead chlamydia bacteria may be detected 3 to 5 weeks after treatment, which would give a false positive result. But, if you have a rectal infection, you should have a test after treatment is completed.

If you are under 25 and have tested positive for chlamydia, it is recommended you take a repeat test 3 months after completing your treatment, to check you have not caught chlamydia again.

Can chlamydia come back after treatment?

In some cases, you may test positive for chlamydia again after treatment.

This could happen if you:

• had unprotected sex before completing your treatment
• did not take your antibiotics correctly