Chlamydia, caused by the bacterium chlamydia trachomatis, is a prevalent STD that affected 1,758,668 people in the US, in 2018. Chlamydia patients are often asymptomatic, meaning they might spread the disease because they are not aware they have it. Screening tests are necessary to identify chlamydia cases in adults and teenagers. Chlamydia left untreated can lead to severe complications in both sexes. Chronic chlamydia infection can result in permanent infertility in women. The disease can also affect your unborn child, if not identified and treated early. Pregnant women are also at high risk for chlamydia, when sexually active. Chlamydia is easily curable with antibiotics. However, as the disease progresses and affects other organs, it gets more challenging to treat.

What are the symptoms of chlamydia, and do they facilitate diagnosis?

Most chlamydia cases are asymptomatic in both sexes. Chlamydia causes genitourinary infections, meaning it affects the genitals and urinary system. It causes urethritis in men and, initially, vaginitis in women, but if left untreated, it could lead to severe complications. Men might experience disturbances upon urination or penile discharge, although they usually don't have any symptoms. Women might present with intermittent vaginal bleeding, discharge, and dysuria. In the case of an anal infection, individuals might experience pain, bleeding, or discharge from the anus. Therefore, the clinical presentation of chlamydia has a high heterogeneity and sometimes is silent. Patients should not wait until they experience symptoms to get tested but should evaluate any potential exposure before it is too late. Many people today take control of their sexual health and get tested alone at home with an STD kit test. 

Who should screen for chlamydia?

Certain population groups should screen more often for chlamydia than other people. The Centers for Disease Control and Prevention recommends chlamydia screening for young girls aged twenty-five-year-old or younger, ladies who are pregnant, and individuals at high risk. The rate of chlamydia is highest among young adults. Doctors recommend yearly screening done with a test. Pregnant women should screen during their first prenatal exam. Individuals at high risk are those who are non-monogamic, have unprotected sex, have another STI, or are men who have sex with men. Guidelines recommend retesting after completion of the treatment. 

What are the test options for chlamydia patients?

There are many different types of tests to diagnose or screen for chlamydia. The two most simple ones are through a urine sample or a swab. Men can take a swab from their urethra or anus and women from their cervix or anus. Oral swabs are available too for those that engage in receptive oral sex. Some people prefer to swab themselves alone at home with an STD rapid kit test. Research suggests that self-swabbing is just as effective as a swab obtained by a physician. Make sure to get tested again three months after your treatment. 

Chlamydia diagnosis test without lab

How to use an STD rapid kit test for chlamydia

It is best to test for chlamydia in the first five days after exposure. The chlamydia screen test is a qualitative test for the detection of Chlamydia trachomatis antigen in urogenital specimens. Before you use the kit, make sure you read and understand the instructions. The procedure is slightly different in men and women. If you are a man, you have to take a swab from the interior of your urethra. Women need to insert the swab through the vagina, collect a specimen, and withdraw the swab carefully without touching the walls of the vagina. Both sexes have to follow the same procedure after swab collection. Finally, you have to interpret the results. If you are unsure of the instructions, watch the video to facilitate yourself. It provides you with simple instructions and shows you how to execute the whole testing procedure. 

Treatment of chlamydia

A simple and uncomplicated chlamydia infection requires a single antibiotic, such as azithromycin or doxycycline. However, most people with chlamydia present with coexisting gonorrhea infection. Therefore, doctors recommend dual therapy to cover both diseases, except if there is not a second diagnosis. Alternatives with those intolerant or allergic to azithromycin or doxycycline are the following:

  • erythromycin
  • erythromycin ethylsuccinate
  • levofloxacin
  • ofloxacin 

Women that get a diagnosis of chlamydia during their pregnancy should receive azithromycin or amoxicillin. In the case of intolerance or allergies in these drugs, doctors usually recommend erythromycin and erythromycin ethylsuccinate as an alternative. Following the completion of the treatment, physicians recommend a test of cure. The correct timing of retesting is three to four weeks after completion of the initial treatment in pregnant women. Non-pregnant women and men should get tested again after three months. Patients should abstain from any sexual activity until they complete their treatment. HIV-positive individuals require the same pharmaceutical regimen as HIV-negative people. 

Complications of chlamydia in women

The following are some of the most well-established outcomes of untreated chlamydia in women:

  • pelvic inflammatory disease
  • infertility
  • perihepatitis (Fitz-Hugh-Curtis syndrome)
  • chronic pelvic pain
  • ectopic pregnancy
  • increased susceptibility to HIV
  • reactive arthritis
  • adult inclusion conjunctivitis

Complications of chlamydia in pregnant women

The following are some of the most well-established outcomes of untreated chlamydia in pregnant women and their babies:

  • miscarriage
  • premature rupture of membranes
  • preterm labor 
  • low birth weight
  • infant death
  • reactive arthritis
  • neonatal pulmonary infection
  • eye infection
  • adult inclusion conjunctivitis

Complications of chlamydia in men

The following are some of the most well-established outcomes of untreated chlamydia in men:

  • epididymo-orchitis
  • infertility
  • increased susceptibility to HIV
  • reactive arthritis
  • adult inclusion conjunctivitis

Prevention of chlamydia and its complications

There are many ways to prevent chlamydia infection. However, the two most effective ones are abstaining from sex or being in a long-term, mutually monogamous relationship. Generally, doctors recommend avoiding high-risk sexual behaviors such as practicing casual unprotected sex or having multiple partners. You might also be at high risk if you are monogamous, but your partner is not. Sexual protection, such as condoms or dental dams, decrease the risk of acquiring chlamydia significantly. Another preventive measure against chlamydia is educating teenagers and young adults about the importance of safe sex and the consequences of risky sexual behaviors. Young people should understand chlamydia is a very prevalent disease that can happen to anyone, regardless of their sex, color, education, or socioeconomic status.