chlamydia: public enemy number one
by John Illman
Chlamydia is the UK's most common sexually transmitted infection. Untreated chlamydial infection in women can lead to painful pelvic inflammatory disease (PID), which may in turn result in infertility and ectopic pregnancy (pregnancy occurring outside the womb). PID can also cause fever and may even be life-threatening in rare cases. In men, chlamydia can cause painful testicular infection and may reduce fertility. Fortunately, if caught early on, chlamydia is easily treated with antibiotics.
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young people most at risk
Young people, especially women, are the most at risk. More than 45,000 new infections are diagnosed in sexual health clinics each year, according to a recent report. It warns that the number of cases reported in England in the last 10 years has risen by nearly 50%. It has been estimated that up to 1 in 10 young people might have chlamydia.
About three-quarters of infected women and about half of infected men do not develop any symptoms. Because of this, a national programme of screening for chlamydia in sexual health clinics began being rolled out in 2002. The programme will primarily target women under 25, but the Department of Health said that they will also be promoting greater uptake of testing amongst men.
what are the symptoms in those who do have them?
In women:
- An unusual vaginal discharge
- Pain when passing urine
- Bleeding between periods (including women who are using hormonal contraception)
- Bleeding after sex
- Pain and/or bleeding when you have sex
- Lower abdominal pain.
In men:
- A white/cloudy and watery discharge from the tip of the penis
- Pain when passing urine
- Painful swelling of the testicles.
relationship problems
Naomi, 26, was diagnosed with chlamydia last year while undergoing fertility tests – she and her partner had been trying for a baby for 18 months. She recalls: 'We were devastated. I don't know when I was infected, but it must have been some time ago because I'm now infertile.'
It can be difficult for couples like Naomi and Terry to know for how long they have been infected – and by whom. A spokeswoman for fpa (Family Planning Association) said: 'Many people are left in doubt as to whether they have got chlamydia from their current or a previous partner. These doubts can be hard to handle. Some people feel upset and angry when they have an STI like chlamydia and find it hard to talk to their partner or friends. We encourage them to talk about their feelings with the staff at the clinic or surgery.'
reducing the risk with safe sex
Chlamydia is passed from one partner to another during sex. The bacteria can live inside the cells of the cervix (the womb entrance), the urethra (where urine comes out), the rectum (back passage), the throat and eyes. Babies born to mothers with chlamydia infection are susceptible to eye infection.
Infection can be spread by vaginal, anal and oral sex or by shared sex toys. Condom use will reduce your chance of getting or passing on the infection.
If you develop chlamydia without showing any symptoms, you will not know unless you have a test. fpa advises testing if:
- You have had unprotected sex with a new partner recently
- You or your partner has had unprotected sex with other partners
- A vaginal examination shows that the cells of your cervix are inflamed or if you have a discharge
- A sexual partner tells you they have an STI
- You are found to have another STI.
testing takes 'only a few seconds'
Chlamydia will show up on a test within a few days of infection. Available at GUM clinics, sexual health clinics and GP surgeries, tests only take a few seconds and are not painful – though they may cause momentary discomfort. A doctor or nurse may use a swab to take a sample of cells from:
- the cervix
- the urethra
- the rectum
- the throat
- the eye.
If you want to know more about what happens at a sexual health clinic, check out our feature.
antibiotic therapy
Several different antibiotics, taken either in a single dose or a longer course, are used to treat chlamydia. The doctor may recommend starting treatment before your test results come back if there is a high chance of you having the infection.
fpa warns: 'Some antibiotics used to treat chlamydia interact with the contraceptive pill. If you're taking the pill, tell the doctor or nurse so that they can advise you what to do. You should also tell the doctor or nurse if you are, or think you might be, pregnant – or if you're breastfeeding. This will influence the type of antibiotic you have.'
Chlamydia is also associated with early miscarriage or premature birth of the baby. It can be passed to the baby during birth and, less commonly, beforehand. Antibiotic treatment for chlamydia during pregnancy will not harm your baby, but fpa says: 'Do tell the doctor or nurse you are pregnant.'
help and info
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organisations
Brook
421 Highgate Studios
53-79 Highgate Road
London NW5 1TL
Helpline: 0800 0185 023 (Mon-Fri 9am-5pm)
E-mail: admin@brookcentres.org.uk
Website: www.brook.org.uk
Provides free and confidential sexual health advice and contraception for anyone under 25. The website has tons of useful information including a secure on-line enquiry service and a text messaging service.
FPA
50 Featherstone Street
London EC1Y 8QU
Helpline: 0845 310 1334 (Mon-Fri 9am-6pm)
fpa Scotland: 0141 576 5088 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
fpa Northern Ireland: 028 90 325 488 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
Website: www.fpa.org.uk
The fpa can advise on all sexual health matters, including contraception, abortion and sexual health. A range of factsheets are available to download free from the website. You can also get details of family planning clinics, sexual health clinics and other sexual health services anywhere in the UK.
National Chlamydia Screening Programme (NCSP)
Tel: 0208 327 7436/7414
Website: www.chlamydiascreening.nhs.uk
The NCSP in England works to ensure that all sexually active young people under 25 are aware of chlamydia and have access to services providing screening, prevention and treatment.
NHS Direct
Helpline: 0845 4647 (24 hours)
Website: www.nhsdirect.nhs.uk
The NHS 24-hour service provides expert health advice from trained nurses. An extensive database of medical information is available on their website. They can also advise you if you wish to make a complaint about the NHS.
Sexual Health Line
Tel: 0800 567 123
Textphone: 0800 521 361
Gives confidential advice and information about STIs or any other aspect of sexual health. Can also tell you where to find local sexual health services. Lines are open 24 hours a day.
websites
Association for Genito Urinary Medicine (AGUM)
www.bashh.org/directory.htm
Online directory of GU medicine clinics for the UK and Republic of Ireland.
AVERT
www.avert.org
Information for young people about HIV infection and AIDS, sex, puberty, sexuality, contraception and condoms. Includes personal stories, articles and resources such as quizzes, statistics, FAQs and printable booklets.
Condom Essential Wear
www.condomessentialwear.co.uk
For more information on condoms, sexual health, how to protect yourself from STIs and how to find your nearest GUM Clinic.
Sexually Transmitted Infections (STIs)
www.nhsdirect.nhs.uk/...
Straightforward but brief outline of sexually transmitted infections (STIs) and their treatments. Part of the NHS Direct website.
Society of Sexual Health Advisers
www.ssha.info
Contains answers to frequently asked questions about STIs, information about infections and treatments, a discussion forum and details of GUM clinics around the UK.
reading
Sexually Transmitted Diseases by Derek Llewellyn-Jones (Faber and Faber, 1990) |
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Sexually Transmitted Diseases by Lisa Marr (The Johns Hopkins University Press, 1999) |
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Sexually Transmitted Infections by Mary-Claire Mason (Sheldon Press, 2002) |
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'Screening Men for Chlamydia trachomatis' by K Fenton in The Journal of Communicable Disease and Public Health, vol no. 3, 2 June 2000, pages 86-89.
Can be downloaded as a PDF from the Health Protection Agency website.
(updated February 2005)
