Chlamydia: Our Number One Std Problem

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Chlamydia is a disease caused by the bacteria Chlamydia trachomatis. It is the most common sexually transmitted disease (STD) in the U.S. today. In 2008, over 1.2 million cases of Chlamydia were reported to the Centers for Disease Control (CDC) [Source: CDC website]. This projects out to at least 3-4 million cases annually, due to vast under-reporting of cases. In my many years of practice, I have (on average) diagnosed at least 5 to 15 cases each year.

Symptoms of Chlamydia

As many as 25% of men with chlamydia have absence of symptoms. In men, chlamydia may produce symptoms similar to gonorrhea. Symptoms, when present, tend to include:

  • Burning with urination (called dysuria)

  • Discharge from the penis (usually milky or beige)

  • Testicular tenderness or pain

  • Rectal area discomfort

Only about 30-35% of women with chlamydia have active symptoms. Common symptoms in women include:

  • Dysuria

  • Painful intercourse

  • Vaginal discharge or itching

  • Rectal pain

  • Pelvic pain

How is Chlamydia Diagnosed?

If the doctor suspects Chlamydia, he/she will obtain

  • History: usually there is history of recent unprotected sex

  • Physical: often penile or vaginal discharge is present

  • Lab tests: either by urine sample or by genital swab, there are accurate tests that can confirm or rule out chlamydia

How is Chlamydia Treated

The primary method of treatment for chlamydia includes appropriate antibiotic treatment. The most common antibiotics prescribed are:

  • Azithromycin

  • Tetracyclines, such as doxycycline

  • Erythromycin

It is critical that all sexual partners be treated, to prevent passing the infection back and forth. A follow-up evaluation may be done in four to six weeks to determine if the infection has been cured.

Prognosis for Chlamydia

Early antibiotic treatment is generally successful and tends to prevent the development of long-term complications. Untreated infection, however, may lead to pelvic or prostatic infections, scarring, and ultimately infertility. If you suspect that you might have Chlamydia, it is highly advisable that you see your physician to get a thorough evaluation.

Prevention of Chlamydia

According to the CDC, the surest way to avoid transmission of STDs is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.

CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health care provider should always be conducted and may indicate more frequent screening for some women.

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