Chlamydia Symptoms and Diagnosis

The main thing to know about chlamydia symptoms is that most people don’t notice any. The fact that chlamydia is a so-called silent illness is one big reason that the disease has become so common. It is, in fact, the infection that is most often reported to the Centers for Disease Control and Prevention (CDC) in the United States.

“Most girls and women who have a chlamydia infection don’t know that they have it,” says Julie Dombrowski, MD, MPH, deputy director of the HIV/STD Program for the public health department of Seattle and King County in Washington. Without realizing that there is any problem, these girls and women easily transmit the infection to their sex partners, who often then pass it to others.

If you are among the few girls and women who do have symptoms, they are likely to arise within one to three weeks after you first were exposed to the bacteria. You will be capable of giving another person chlamydia from the time that you are infected until the end of your treatment with antibiotics.

Chlamydia symptoms in girls and women can include the following:

• Vaginal discharge
• Burning sensation when you urinate, because of an inflammation in the tube that carries urine out of the body, the urethra
• Inflammation of the rectum (proctitis)
• Inflammation of the eyelid (conjunctivitis)
• Infections in your mouth and throat that cause soreness and redness, though most oral infections cause no symptoms

If a chlamydia infection spreads into your fallopian tubes, the tubes that allow an egg to leave one of the ovaries and enter the uterus, you may have these symptoms:

• Pain in the lower abdomen or the lower back
• Pain during intercourse
• Bleeding between monthly periods
• Fever
• Nausea

Possible Symptoms in Boys and Men

A chlamydia infection is more noticeable in boys and men who have sex with female partners. These males often have infections in the urethra, the tube through which urine leaves the body. “They will usually have pain or some discharge or irritation when they urinate, so they’re more likely to go get treatment,” says Dr. Dombrowski.

“But for boys having sex with other boys, infection in the rectum is most common and that almost never causes symptoms,” she says.

Although symptoms of chlamydia in the anus or rectum are quite rare, when they do arise they may take the form of rectal pain, discharge, or bleeding, according to the CDC.

More frequent chlamydia symptoms in boy and men include the followings:

• A discharge from the penis. It may be pus, or a watery or milky fluid.
• Pain or swelling of the testicles
• Inflammation of the rectum (proctitis)
• A burning or painful feeling when you urinate, because of inflammation of the urethra
• Inflammation of the eyelid (conjunctivitis)
• Infections in your mouth and throat that cause soreness and redness, though most oral infections cause no symptoms

If you fall into certain groups, whether or not you have signs or symptoms of chlamydia, you ought to be tested for the illness. With regard to women, here are the testing recommendations made by the CDC:

• Sexually active women under the age of 25 should get tested for chlamydia every year.
• Women older than age 25 who have new or multiple sex partners, or have sex with people who have any sexually transmitted disease, should also get tested for chlamydia ever year.
• All pregnant women should be tested to prevent possibly serious harms to their babies.

As for testing in men, the CDC recommends that all gay and bisexual men and other men who have sex with men should get tested. (1)

How Chlamydia Is Diagnosed

There are a number of different, reliable tests for chlamydia. In addition to tests that a healthcare provider would use in a medical office or clinic, there are now some good test kits you can use at home. The tests rely on several different methods.

Some older tests involve obtaining some of the chlamydia bacteria and growing them in a culture. Today, healthcare providers prefer newer DNA tests, often called NAATs (nucleic acid amplification tests).

Some tests that work for both men and women use a urine sample. Others use secretions from the genitals or other infected areas of the body, such as the rectum or back of the throat. While the CDC recommends testing of genital secretions, screening a urine sample is less invasive and more practical for many primary-care physician offices.

To thoroughly test for chlamydia, swabs will need to be taken of all orifices that have been involved in sexual contact; this may include mouth and throat, vagina or penis, and rectum.

Sexually active women under age 25 ought to be tested every year for chlamydia whether or not they have any symptoms. Tests often involve the insertion of a cotton swab into the vagina to obtain secretions.

“Vaginal swab is the preferred method,” says Dombrowski. “You don’t have to have a whole pelvic exam.”

If you are pregnant, you should be screened for chlamydia during your first prenatal visit. If you are pregnant and younger than 25, or if you are pregnant and have a new sex partner or multiple partners, you should also be screened again in your third trimester. It’s important to catch and treat chlamydia in a pregnant woman to prevent transmission to the baby. In newborns, the illness can cause serious harm or death.

Men without symptoms are seldom tested for chlamydia.

For men, a healthcare provider may use urine or take a sample of discharge, often from the penis, and send it to a lab for a test called a PCR (polymerase chain reaction). Urine tests are more common, both for their ease of use and because men frequently have no discharge associated with chlamydia. Test results usually take a day or two to come back.

Home Testing Is Possible

“There are definitely at-home tests that are accurate,” says Dombrowski. “They are easy-to-use and hard to mess up, but the problem is that the kits often cost a lot of money.”

Furthermore, she says that while you can test yourself at home, if the test is positive, you cannot buy the antibiotics that you need to treat the illness over the counter. You will need a prescription from a doctor or other healthcare provider. Also, you will need to retest yourself three months after the treatment ends.

People with one of these STDs frequently have the other as well. “They often go together,” says Dombrowski. “They have many of the same risk factors, and they are spread the same way.”

In fact, she says, chlamydia was actually first discovered when people who had gonorrhea were treated but still had symptoms.

If you test positive for chlamydia, your healthcare provider is likely to also recommend that you be treated for gonorrhea. This is because the cost of treating gonorrhea is less than the cost of testing for the infection.

Regular Screening Prevents Later Problems

When young women and other women at high risk for chlamydia follow CDC guidelines and get yearly screening, they reduce their risk for the serious problems that the illness can cause. They are less likely to suffer infertility, pelvic inflammatory disease, and other serious health troubles than women who skip yearly testing.

Testing is easy. If it helps you remember, do it the week after your birthday, or tie it to some other annual event, like the 4th of July. That way, you can declare your independence from worry about STDs.