How do you get chlamydia in your mouth?

Oral chlamydia is still sexually-transmitted – as chlamydia is a sexually transmitted infection, by definition, the infection is passed on by having a sexual encounter with another person.

Genital and mouth contact – transmission of chlamydia, and indeed other STIs, may also occur with sexual contact between the mouth, the penis, and the rectum. It is unclear if chlamydia can be passed on by kissing or by digital (finger) penetration alone.

Do you always catch chlamydia if you’ve been in contact with someone who has it? – it is impossible to say that you will always catch chlamydia if you have sex with someone else who has it, but there is a strong chance you could get the infection. Chlamydia bacteria are among the smallest bacteria, and millions will occupy one small drop of bodily fluid secretion.

It’s so likely that you can sometimes get treatment without testing – in a sexual health clinic, if you have had sex with someone who is known to have chlamydia, the clinic will treat you with antibiotics anyway, because you have been in contact with the infection. If you have been at risk of chlamydia, it is always better to be safe than sorry. If chlamydia is not diagnosed and goes untreated there can be serious consequences.

How common is mouth chlamydia?

It is difficult to be sure how commonly chlamydia is found in the throat, as study results are varied. In fact, most people with oral chlamydia do not have a sore throat and are unaware of the infection unless they test positive.

It’s not always tested for – the throat is not routinely sampled for chlamydia when you go for an STI screen. This is because current chlamydia tests may produce false positive results and cause anxiety. In addition, the chance of having oral chlamydia is extremely low (see below).

When are people at risk? – in a clinic, you may be offered a throat swab for chlamydia if there are other risk factors such as:

• Men who have sex with men (MSM) 

• Sex workers

• Sexual assault

• Oral sex with a partner known to have chlamydia

• A persistent sore throat unresponsive to standard antibiotics e.g penicillin

Some limited statistics – in one American review study (Chan et al 2016) the prevalence of chlamydia in men and women from swabs taken from the rectum and the throat, was as follows:

• Women:

• Rectum – 2-77.3% (most commonly around 8.3%)

• Throat – 0.2-3% (most common 1.7%)

• Men who have sex with men:

• Rectum – 2.1-23% (most common 8.9%)

• Throat – 0-3.6% (most common 1.7%)

• Men who have sex with women:

• Rectum  0-11% (most common 7.7%) 

• Throat – 0-22% (most common 1.7%)

How can you tell if you have oral chlamydia?

Can you cure mouth chlamydia?

Yes you can – chlamydia in the mouth, just as at other sites of the body, can be treated and completely removed with a simple course of antibiotics. However, it’s important to follow your treatment regime properly to ensure the infection is removed. Also, treatment only removes existing infections and won’t protect you from future infection.

Does oral chlamydia go away on its own? –  if chlamydia is untreated, it is thought that up to 50% of people will clear the infection themselves within 12 months. However, in the remainder of people who don’t clear the infection, a chronic chlamydial infection becomes established, and in the longer term this can result in serious negative medical outcomes.

How does oral chlamydia treatment work? – the first choice antibiotic for chlamydia is the antibiotic doxycycline 100mg taken twice a day by mouth for 7 days (this should not be used in pregnancy.

Make sure you use treatment correctly – it is important that you:

• Take all the antibiotics as instructed – don’t miss any out

• Do not have sex on treatment or for 7 days afterwards, not even oral sex or sex with a condom

• Your current/most recent partners should be tested, and treated as they are contacts

• Attend a sexual health clinic for a full STI screen

Do I need another test after treatment? – usually no, except in the following situations:

• You have to be treated with a different antibiotic to the 2 standard treatments, e.g. erythromycin

• You have rectal chlamydia as well

• You are pregnant

• You are anxious

• You did not comply fully with the treatment regime

If you do get re-tested for your oral chlamydia this is known as Test of Cure – ToC. You need to wait 4-6 weeks from completing treatment to have this test. This is because the test may still test positive if there are dead organisms present, and you may get a false positive result.

What are the risks of not getting treatment? – risks of untreated chlamydia include:

• Pelvic inflammatory disease

• Ectopic pregnancy

• Tubal blockage

• Decreased fertility in men and women

• Acute epididymo-orchitis

• Prostatitis

• Blindness

• Reactive arthritis

Can you treat chlamydia ‘naturally’? – it is not advised you treat chlamydia naturally as natural cures are not proven to work and there are serious risks involved when chlamydia isn’t treated properly. Some products mistakenly believed to be suitable treatments for chlamydia include:

• Garlic

• Echinacea

• Goldseal

• Cat’s claw

How is oral chlamydia related to other chlamydias?

Chlamydia is the name of a group of bacteria – the type of chlamydia that affects genitals and the throat is called chlamydia trachomatis. This is only a subset of chlamydia bacteria and there other types.

Other types of chlamydias – there are some alternative forms of chlamydia to the strain responsible for oral infections, including:

• Lymphogranuloma venereum (LGV) – this can also cause genital infections but is very rare in the UK

• Chlamydia psittaci – which cause a flu-like illness

• Chlamydia pneumoniae – which causes pneumonia in adults

Do tests vary between different types of chlamydia? – yes. The tests for chlamydia will be different even for the same strain of chlamydia depending on where the infection is:

• Throat swab for mouth chlamydia

• Vulvovaginal swab for genital chlamydia in women

• A urine test for genital chlamydia in men

Other different strains or types of chlamydia also require different tests as they affect other parts of the body such as the lungs or eyes.

Does treatment vary between types of chlamydia? – generally not very much. Because different types of chlamydia are still all bacterial infections, they are usually treated with broad spectrum antibiotics like doxycycline.

How do you avoid getting mouth chlamydia?

How to avoid getting infected – the only guaranteed way to avoid chlamydia is not having sex, but this is not a suitable options for most people. To reduce your chance of getting chlamydia you can try the following:

• Choose sexual partners carefully – however difficult, you should try to discuss any previous sexual history with a new partner before you first have sex

• Get tested before the start of a new relationship and do not have unprotected sex until you know your test results and your partners’ – an extended STI test kit which tests for chlamydia, gonorrhoea, HIV and syphilis is recommended

• Use barrier contraception such as the male condom carefully and correctly – always apply the condom before any sexual contact, including oral sex

• If you are diagnosed with chlamydia, always follow the advice about treatment very carefully – try to make sure, if you have had chlamydia once, you don’t get it again and keep getting tested regularly

• Use condoms at the same time as other contraceptives – other contraceptives don’t protect against STIs and using condoms alone as a method of contraception has a high failure rate. Women are advised to use a reliable contraceptive method to avoid an unplanned pregnancy, but to use condoms as well, to reduce the chance of acquiring an STI

Who is it at a higher risk of STIs like oral chlamydia? – risk factors for chlamydia include:

• Young age (< 25 years)

• Multiple partners/frequent change of partner/overlapping partners

• Gay/bisexual men

• Black African/Afro Caribbean partners

• Lack of barrier contraception

• Sex workers/ those working in the pornsex industry

• Drug addicts/homeless/those living in poverty

• Travel and having casual sex abroad

Are other people less likely to get chlamydia? – people most likely to get chlamydia are those listed in the high risk category above. However, chlamydia can occur in anyone, and at any age. It can be detected in newborn babies, if they have been born through an infected birth canal, and in old age pensioners, for a variety of reasons. That’s why it’s always important to reduce your chances of getting chlamydia

Sources

Association for Improvements in the Maternity Services (2002). Ectopic pregnancy: the facts. AIMS Journal, Sept; 14(3).

Chan, P. A. et al (2016). Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A review of the literature. Infect Dis Obstet Gynecol.; 2016.

Harding, M. (2017). Ectopic pregnancy. patient.info. [online]. Available at: https://patient.info/pregnancy/ectopic-pregnancy-leaflet [accessed 3rd August 2020].

Jones, R. B. et al (1985). Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Ann Intern Med, Jun; 102(6): 757-62.

Morgan, R. (2015). Babies born with chlamydia. hellomotherhood.com. [online] Available at: https://www.hellomotherhood.com/article/514899-babies-born-with-chlamydia/ [accessed 3rd August 2020].

NHS Choices (2015). Chlamydia. NHS. [online] Available at: https://www.nhs.uk/conditions/chlamydia/symptoms/ [accessed 26th April 2018].

Public Health England (2016). Sexually transmitted infections and chlamydia  screening in England, 2016. Health Protection Report, Jun; 11(20).