Sexually Transmitted Infections: Chlamydia

Chlamydia is a Sexually Transmitted Infection (STI) caused by a bacteria known as Chlamydia Trachomatis. The bacteria can be spread via sexual contact of infected vaginal or semen fluid. Chlamydia and Gonorrhea are two very common Sexually Transmitted Infections in Singapore.

Am I at risk to catch Chlamydia STI?

You are, if:

  • You have unprotected sexual intercourse
  • You share sex toys that are not cleaned or not covered with condom when used
  • Your genitals come into contact with your partner’s genitals (you can get Chlamydia infection without penetration, orgasm, or ejaculation)
  • Infected semen or vaginal fluid contacting your eye

Symptoms of Chlamydia Infection

Majority of people do not have symptoms even though they are infected with Chlamydia.

70% of females have no symptoms, and at least 50% of men have no symptoms.

Symptoms usually occur 1-3 weeks after exposure and infection, though it can occur months later.

In Female, one may experience:

  • Unusual vaginal discharge
  • Painful urination
  • Lower abdominal pain
  • Pain during sexual intercourse
  • Abnormal bleeding- after sex, between menses

In men, one may experience:

  • Painful urination
  • White, cloudy to colorless discharge from penis
  • Itch or burning sensation over the urethra
  • Painful testicles

Other symptoms:

  • If Chlamydia infection affects the rectum (back passage), you may feel discomfort or abnormal discharge from your rectum.
  • You are unlikely to experience symptoms from your throat if you have unprotected oral sex.
  • You may have eye symptoms such as pain, redness, or abnormal discharge if your eye is in contact with Chlamydia infected semen or vaginal fluid.

Should I get tested for Chlamydia STI?

You should, if:

  • You or your partner have symptoms of Chlamydia infection
  • You had unprotected sex with your partner
  • You or your partner had unprotected sex with other people
  • You have other concurrent STIs
  • Your partner told you they have STI
  • You are pregnant or planning pregnancy

Diagnosis of Chlamydia STI

Testing for Female

  • Chlamydia swab test- This involves an internal examination, where the trained clinician will insert a speculum (plastic device) into your vagina, and use a brush swab to collect a sample from your cervix.
  • Chlamydia urine test-Urine sample may be offered to some female as well.

Testing for Men

  • Urine sample test- You are advised to provide a urine sample for screening of Chlamydia bacteria. It is important to hold your urine for at least 2 hours beforehand, as recent urine ca wash the bacteria away affecting the test results.

In cases where the concerns of rectum, throat, or eyes are infected, your doctor may offer swab tests to collect samples from the affected areas.

Currently, there is a single test to detect Neisseria Gonorrhea and Chlamydia Trachomatis bacteria. This is to screen concurrently for both STIs under one setting. Speak to your doctor on CTNG PCR DNA swab/ urine tests.

Treatment of Chlamydia STI

Good news, more than 95% of people can be successfully treated if they take their antibiotics.

You may start taking your antibiotics once the results confirmed your Chlamydia infection.

In cases when you are at risk of Chlamydia infection, or your partner has confirmed Chlamydia infection, you may be offered treatment even before your test results out.

Antiobiotics treatment options:

  • Azithromycin – 4 tables all in 1 day, or
  • Doxycycline- 2 tablets for 1 week

You may be advised for different antibiotics if you have a drug allergy, pregnant, breastfeeding or other concerns of bacteria resistance. Your duration of antibiotics may be longer if there are concerns about complications from Chlamydia infection.

You are advised to abstain from sex until you and your partner have completed the medical treatment. If you had the 1-day course of treatment, you are advised to avoid sex for at least 1 week.

It is advisable for your current or other recent sexual partners to get tested. This is to ensure you don’t pass on the infection, or catch it back straight away.

Why should we treat Chlamydia STI?

If Chlamydia infection is left untreated, in female, it can lead to Pelvic Inflammatory Diseases (PID), by affecting other reproductive organs such as the womb, the fallopian tubes or the ovaries. In the long term, this can lead to chronic pelvic pain, increase the risk of ectopic pregnancy or even causing infertility.

Women with untreated Chlamydia infection and are pregnant can pass the infection to the baby. Baby can be born prematurely and can be at risk of low birthweight. Your baby may be at risk of developing lung infection and eye infection.

In men, Chlamydia infection can cause inflammation of the testicles, a condition known as epididymitis. If left unattended can affect men fertility.

Rarely, Chlamydia infection can affect your joints, eyes, and urinary tract system. This is a condition known as Sexually Acquired Reactive Arthritis (SARA). Although women can be affected as well, it is more common in men. Speak to your doctor regarding treatment options.

How do I prevent acquiring Chlamydia STI?

  • Use barrier contraception such as male condoms or female condoms every time during sexual intercourse
  • Do not share sex toys, wash and cover them with condom before anyone uses them

Be safe, practise safe sex.

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