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Chlamydia - Complications - NHS

If chlamydia isn't treated, it can sometimes spread and cause potentially serious problems.

Complications in women

Pelvic inflammatory disease (PID)

In women, chlamydia can spread to the womb, ovaries or fallopian tubes. This can cause a condition called pelvic inflammatory disease (PID).

PID can cause a number of serious problems, such as:

• difficulty getting pregnant or infertility
• persistent (chronic) pelvic pain
• an increased risk of ectopic pregnancy (where a fertilised egg implants itself outside the womb)

The symptoms of PID are generally similar to the symptoms of chlamydia, including discomfort or pain during sex, pain during urination, and bleeding between periods and after sex.

PID is usually treated with a 2-week course of antibiotics. The risk of experiencing problems such as infertility is lower if it's treated early, so it's important to seek medical advice as soon as possible if you have symptoms of the condition.

Pregnancy complications

If you have chlamydia that's not treated while you're pregnant, there's a chance you could pass the infection on to your baby. If this happens, your baby may develop an eye infection (conjunctivitis) and lung infection (pneumonia).

If your baby has symptoms of these conditions, your midwife or GP can arrange for a test to check for chlamydia, and antibiotics can be used to treat the infection.

Untreated chlamydia in pregnancy may also increase the risk of problems such as premature labour and birth (before 37 weeks of pregnancy) or your baby being born with a low birthweight.

Complications in men

Inflammation of the testicles

In men, chlamydia can spread to the testicles and epididymis (tubes that carry sperm from the testicles), causing them to become painful and swollen. This is known as epididymitis or epididymo-orchitis. This is very rare.

The inflammation is usually treated with antibiotics. If it's not treated, there's a possibility it could affect your fertility.

Reactive arthritis

Chlamydia is the most common cause of sexually acquired reactive arthritis (SARA). This is where your joints, eyes or urethra (the tube that passes urine out of the body) become inflamed, usually within the first few weeks after having chlamydia.

It can affect women who have had chlamydia but is more common in men.

There's currently no cure for SARA, but most people get better in a few months. In the meantime, treatment with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help relieve the symptoms.

Page last reviewed: 01 September 2021
Next review due: 01 September 2024

Chlamydia - KVD №2

What is chlamydia?

Chlamydia is a common sexually transmitted infection (STI). The disease is caused by the bacterium Chlamydia trachomatis (Chlamydia trachomatis), which affects the female genital area and is the cause of non-gonococcal urethritis in men. Manifestations of chlamydia are usually minor or absent, but serious complications develop. Complications can cause irreparable damage to the body, including infertility - all this proceeds very secretly.

Chlamydia also causes penile discharge in infected men.

Chlamydia transmission routes

Chlamydia can be transmitted through:

• vaginal or anal contact with an infected partner;
• less common with oral sex;
• use of sex toys with an infected partner;
• infection of a newborn during childbirth from a sick mother.

Absolutely all sexually active people can get chlamydia. The greater the number of sexual partners, the greater the risk of infection. The risk of infection is especially high in girls, because their cervix is ​​not fully formed. About 75% of new cases occur in women under 25 years of age. By the age of 30, approximately 50% of sexually active women have had chlamydia. In sexually active men, the risk of infection is highest between the ages of 20 and 24.

You cannot get chlamydia through kisses, hugs, dishes, baths, towels.

Manifestations of chlamydia

Chlamydia is very secretive. About 75% of infected women and 50% of infected men are asymptomatic. If manifestations of the disease develop, then this occurs approximately 1 to 3 weeks after infection.

In women, chlamydia first affects the cervix and urethra (urinary canal).

Manifestations:

• unusual vaginal discharge;
• pain or discomfort when urinating;

If the infection penetrates to the appendages, manifestations are possible:

• pain in the lower abdomen;
• pain in the lumbar region;
• nausea;
• slight increase in temperature;
• pain during intercourse or bleeding after it;
• bleeding between periods.

Symptoms in men:

• clear or cloudy discharge from the penis;
• pain or discomfort when urinating;
• there may be burning and itching in the area of ​​the outlet of the urethra;
• rarely pain and/or swelling of the testicles.

Men or women who have anal sex with an infected partner can infect the rectum, resulting in inflammation, pain, discharge, or bleeding from the rectum.

Chlamydia can cause sore throat (pharyngitis) in men and women who have oral contact with an infected partner.

What complications can develop if chlamydia is not treated?

If the disease is not treated, serious short-term and persistent complications develop. Like the disease itself, complications often occur insidiously.

In women with untreated chlamydia, infection can spread from the urethra to the fallopian tubes (the tubes that carry the egg from the ovaries to the uterus) - this causes (in 40% of cases) the development of pelvic inflammatory disease (PID). PID causes permanent damage to the fallopian tubes, uterus, and surrounding tissues. Chronic pelvic pain, infertility and ectopic pregnancy are the result of PID.

Women with chlamydia are more susceptible to HIV infection, the risk increases by almost 5 times.

To prevent serious consequences of chlamydia, annual chlamydia screening is required for all sexually active women 25 years of age and younger. An annual examination is necessary for women over 25 who are at risk (new sexual partner, multiple sexual partners). All pregnant women should be screened for chlamydia.

Complications of chlamydia are rare in men. The infection sometimes extends to the epididymis and causes pain, fever, and, rarely, male infertility (sterility).

Rarely, chlamydial infection can cause inflammation of the joints in combination with skin lesions, inflammation of the eyes and urinary tract - this is the so-called Reiter's syndrome.

The effect of chlamydia on a pregnant woman and her child

Chlamydia in pregnant women increases the risk of miscarriage, premature detachment of the placenta. Newborns from infected mothers can get eye and lung infections. A lung infection (pneumonia) can be fatal to a newborn.

Diagnosis of chlamydia

Diagnosis includes observation of the patient's clinical symptoms, testing for chlamydia smears from the cervix, scraping from the urinary canal, the first morning urine. Most often, the study is carried out by PCR (polymerase chain reaction). Swabs and scrapings may cause minor discomfort.

In addition, a blood test by ELISA (enzyme-linked immunosorbent assay) for the presence of immunity to chlamydia is carried out, this auxiliary test often helps to establish an accurate diagnosis.

Treatment of chlamydia

Treatment of chlamydia is with oral antibiotics. To prevent re-infection, all sexual partners must be found, examined and treated. Patients with chlamydia should refrain from unprotected sex during treatment, otherwise it is possible to re-infect the sexual partner. Unfortunately, after successful treatment, re-infection with chlamydia is possible, since a strong immunity to this microorganism does not develop. Repeated infection of women with chlamydia leads to a significant increase in the risk of serious complications, including infertility. A re-examination is carried out 4 weeks after treatment.

Prevention of chlamydia

The best way to prevent sexually transmitted infections is through long-term sexual contact with one healthy sexual partner. Latex male condoms, when used correctly, drastically reduce the risk of transmission.

Annual chlamydia screening required for all sexually active women 25 years of age and younger. An annual examination is also necessary for women over 25 who are at risk (new sexual partner, multiple sexual partners). All pregnant women should be screened for chlamydia.

Any manifestations, such as pain or discomfort when urinating, unusual rash, discharge are a signal to stop sexual intercourse and immediately examine in a specialized clinic - KVD. If the patient is found to have chlamydia (or any other STI), he must inform his sexual partners so that they also undergo a full examination and appropriate treatment. This will reduce the risk of developing serious complications and prevent the possibility of re-infection.

Patients with chlamydia should refrain from unprotected sex during treatment, otherwise the sexual partner may be re-infected.

Reproductive Health Education CenterReproductive Health Education Center

Pregnancy is a happy period in every woman's life. Everyone knows how important it is to take care of your health during this period, because during pregnancy any infection is dangerous not only for the mother, but also for the health of the unborn baby. In pregnant women, immunity is always slightly reduced: a change in the immune status is a physiological response to pregnancy. Reduced immunity is necessary for the expectant mother so that her body does not reject the fetus, perceiving it as a foreign object. That is why the body of the expectant mother during pregnancy becomes extremely vulnerable to infections that lie in wait for a woman at every turn. Unfortunately, no one is immune from various diseases during this period. Venereal diseases are no exception. In particular, chlamydia is quite common during pregnancy.

The effect of chlamydia on pregnancy can be extremely detrimental, which is why it is very important to know what the symptoms of the disease are, how dangerous chlamydia is for the unborn child, how to treat the infection so as not to harm the fetus.

The danger of chlamydia in pregnant women lies in the fact that very often it occurs in a latent form. After a rather long incubation period, mild signs of the disease may appear, which are easy to mistake for a common ailment, but they may be absent altogether if the woman does not suffer from serious diseases and immunodeficiency. If chlamydia is not recognized in time in the blood of a pregnant patient, they can cause premature miscarriage or intrauterine infection of the fetus, which often leads to serious malformations and disorders in the formation of the body of the unborn baby.

What is Chlamydia trachomatis?

The nature of the pathogen easily explains why chlamydia is so difficult to recognize and treat. Chlamydia are intracellular parasites. They combine the features of bacteria and viruses at the same time. They are much larger than bacteria, but do not reach the usual size of viruses. Getting into the external environment, chlamydia quickly die, so the disease is not transmitted by contact-household method. Once in the human body, the pathogen begins to feed on energy from the cells, affecting the genitourinary system. Chlamydia during pregnancy affects not only the vulva, cervix, fallopian tubes and ovaries, but also the fetal membranes. This is especially dangerous for the health and life of the unborn child.

Causes of the disease
The source of the disease is an infected sexual partner. Chlamydia is transmitted exclusively through sexual intercourse, if barrier contraception was not used during sexual intercourse. A woman's sexual partner may be a carrier of chlamydia, but due to the latent course of the disease, he may not be aware of its existence. That is why it is so important during pregnancy to undergo a comprehensive examination for the presence of a variety of diseases, which includes PCR for chlamydia. Timely detected chlamydia is treated quite successfully (see a detailed article about the treatment of chlamydia during pregnancy). Pregnancy after treatment and during it proceeds in most cases favorably if the doctor recognizes the infection in time and takes all measures to eliminate it safely and effectively.

The cause of intrauterine infection of the fetus is the penetration of chlamydia into the fluid surrounding the fetus. After infection of the fetal membrane, the infection of the fetus itself also occurs, since the child, while in the womb, regularly swallows a small amount of amniotic fluid.

Why are chlamydia dangerous during pregnancy?
In addition to its usual complications, chlamydia in pregnant women can lead to the following adverse effects:

• Complicated pregnancy, threatened miscarriage
• Early and late miscarriages
• Intolerable toxicosis
• Inflammatory processes in the endometrium, inflammation of the mucous membranes of the uterus and vagina
• Inflammation of the amniotic membrane, negatively affecting the development of the child, since the amniotic membrane is involved in the supply of nutrients to the fetus
• Increased risk of preterm birth
• Development of intrauterine diseases in a child (anemia, pneumonia, conjunctivitis). Chlamydia affects the mucous membrane of the child's eyes, as well as the upper respiratory tract and lungs.
• It is very common for pregnant women with chlamydia to give birth to premature babies.

How does chlamydia present during pregnancy?

Symptoms of the disease are identical to normal chlamydia. Usually the signs are quite weak and resemble urethritis or cystitis. A woman experiences discomfort and burning during urination, scanty and cloudy discharge from the urethra is observed. The discharge may contain pus. Pain in the lower abdomen and pain when urinating often cause the initial stage of chlamydia to be mistaken for cystitis.

In some cases, chlamydia in pregnant women can occur without inflammation in the urinary tract. The infection immediately affects the inner lining of the uterus, as well as the mucous membrane of the cervix. There is swelling of the cervix, its epithelium begins to collapse, erosion of varying severity develops.

Due to hormonal changes, a pregnant woman may also develop chlamydial colpitis (inflammation of the vagina), which is not typical for ordinary patients.

How to treat chlamydia in pregnant women?

As mentioned above, the most important stage from which treatment begins is the recognition of infection, for which serious examinations are prescribed. As for the treatment itself, not all antibacterial drugs are suitable for pregnant women. The task for the doctor in this case is complicated, since he will not only have to draw up an individual treatment regimen, but also choose antibiotics that will be as safe as possible and will not have contraindications. Most often, antibiotics of the tetracycline group are used to treat chlamydia, but they are highly undesirable for use during pregnancy. In this regard, doctors use antibiotics from the pharmacological group of macrolides to treat expectant mothers. Drugs are also prescribed to eliminate dysbacteriosis and restore the normal microflora of the vagina, as well as drugs that stimulate and strengthen the immune system.

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