Chlamydia

Most people with chlamydia won’t have any obvious signs or symptoms, or will have symptoms so mild they’re not noticed.

Signs and symptoms can show up 1–3 weeks after coming into contact with chlamydia, many months later, or not until the infection spreads to other parts of your body. You might notice:

If you have a vulva

• bleeding between periods and/or heavier periods (including women using hormonal contraception)
• bleeding after sex
• pain and/or bleeding when you have sex  
• lower abdominal pain (pelvic pain) 
• an unusual vaginal discharge  
• pain when passing urine

If you have a penis

• a white/cloudy or watery discharge from the tip of the penis
• pain when passing urine
• pain in the testicles.

Other parts of the body

There are rarely any symptoms if the infection is in the rectum (back passage) but it may cause discomfort and discharge.

Infection in the throat is less common than genital infection and usually has no symptoms.

Infection in the eyes can cause pain, swelling, irritation and/or discharge.

How will I know if I have chlamydia?

You can only be certain you have chlamydia if you have a test.

Anyone can get chlamydia. You’re more likely to have it if you’re under 25, have a new sexual partner, or more than one sexual partner in the last year, and if you haven’t used condoms.

You should have a test if:

• you, or a partner, have or think you might have symptoms;
• you’ve recently had sex without a condom with a new partner;
• you, or a partner, have had sex without a condom with other partners;
• during a vaginal examination, your doctor or nurse says that the cervix is inflamed and/or there’s an unusual discharge;
• a sexual partner tells you they have a sexually transmitted infection(STI);
• you have another STI.

If you live in England, and you’re a woman who is under 25 and sexually active, it’s recommended that you have a chlamydia test when you change sexual partner and once a year.

If you’re a man who is under 25 and sexually active, it’s recommended that you have a chlamydia test once a year if you are not using condoms with new or casual partners.

You could still have chlamydia even if a partner has tested negative. The only way to make sure you don’t have chlamydia is to get tested yourself.

If you have chlamydia, you’ll be encouraged to be tested for other STIs as you can have more than one STI at the same time.

It’s caused by bacteria (tiny, living cells) called Chlamydia trachomatis.

In people with chlamydia, the bacteria are most commonly found in the cervix (entrance to the uterus – womb) and urethra (tube where urine comes out). The bacteria can also infect the throat and rectum (back passage).

Anyone who’s sexually active can get chlamydia and pass it on. You don’t need to have lots of sexual partners.

Chlamydia is usually passed from one person to another through sexual contact.

You can get the infection if you come into contact with the semen (cum or pre-cum) or vaginal fluids of someone who has chlamydia.

Chlamydia is most commonly spread through:

• vaginal or anal sex without a condom
• sharing sex toys that aren’t washed or covered with a new condom each time they’re used.

It can be spread by giving or receiving oral sex (going down, giving head) with someone who has chlamydia. The risk can be lowered by using a condom or a dam (a latex or soft plastic square) to cover the genitals.

If infected semen or vaginal fluid comes into contact with the eye (for example if it’s transferred from the genitals to the eye by the fingers) it can cause conjunctivitis (infection or irritation of the eye.

If you’re pregnant it’s possible to pass chlamydia to the baby (see What happens if I get chlamydia when I'm pregnant? in the Other things to know section).

It’s not clear if chlamydia can be spread by transferring infected semen or vaginal fluid to another person’s genitals on the fingers or through rubbing vulvas (female genitals) together.

You can’t get chlamydia from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.

How soon after sex can I have a test?

It’s important not to delay going for a test if you think you might have chlamydia. A test can be carried out straight away but you may be advised to have another test two weeks after having sex. You can have a test for chlamydia even if you don’t have any symptoms.

What does a chlamydia test involve?

• If you have a vulva, you may be asked to take a swab around the inside of your vagina yourself.
• A doctor or nurse may take a swab during an internal examination of your vagina and cervix (entrance to the womb).
• You may be asked to provide a urine sample. Before having this test, you’re advised not to pass urine (pee) for 1–2 hours.
• A doctor or nurse may take a swab from the entrance of the urethra (tube where urine comes out).
• If you’ve had anal or oral sex, a doctor or nurse may swab your rectum (back passage) or throat (you may be given the option to do your own tests). These swabs aren’t done routinely on everyone.
• If you have symptoms of conjunctivitis (an eye infection) swabs will be used to collect a sample of discharge from your eye(s).

A swab looks a bit like a cotton bud but is smaller and rounded. It sometimes has a small plastic loop on the end rather than a cotton tip. It’s wiped over the parts of the body that could be infected. This only takes a few seconds and isn’t painful, though it may be uncomfortable for a moment.

Cervical screening (smear tests) and routine blood tests don’t detect chlamydia.

If you’re not sure whether you’ve been tested for chlamydia, just ask.

How accurate are the tests?

The accuracy of a chlamydia test depends on the kind of test used and the type of sample that’s collected. The recommended tests are over 95% accurate in picking up chlamydia. As no test is 100% accurate there’s a small chance that the test will give a negative result when you do have chlamydia. This is known as a false negative result. This can sometimes explain why you might get a different result from another test or why you and a partner might get a different test result.

It’s possible for the test to be positive if you haven’t got chlamydia, but this is rare.

Where can I get a test?

There are a number of services you can go to. Choose the one you feel most comfortable with.

A chlamydia test can be done at:

• a genitourinary medicine (GUM) or sexual health clinic
• your general practice
• contraception and young people’s clinics
• some pharmacies.

Abortion clinics, antenatal services and some gynaecology services may also offer a chlamydia test.

In England, if you’re a woman aged under 25 years old, you may be offered a chlamydia test as part of the National Chlamydia Screening Programme (NCSP) when you visit some service for other reasons, for example at a pharmacy or your GP. 

The NCSP aims to identify people without symptoms to reduce the complications of untreated infection.  If chlamydia is not treated, it can cause health complications, especially in women.  Untreated chlamydia in women can cause pain in the pelvis, ectopic pregnancy (a pregnancy in the fallopian tubes) and infertility (being unable to have children).

If you are a woman aged under 25 years old and you are offered a chlamydia test as part of the NCSP you should consider taking it. 

In many areas, free home self-sampling tests for chlamydia are available to order online. This is where you take your own sample and send it to be tested. See www.nhs.uk

It’s also possible to buy a chlamydia test to do at home. The accuracy of these tests varies. Some types are very accurate when carried out according to the instructions, others can be less reliable. If you buy a testing kit make sure you get advice from a pharmacist or your doctor.

You can also choose to pay for a chlamydia test at a private clinic.

Will I have to pay for tests?

All tests are free through NHS services and the National Chlamydia Screening Programme. Treatment from these services is also free (see Treatment).

Will I know how long I've had the infection?

A chlamydia test can’t tell you how long the infection’s been there.

If you feel upset or angry about having chlamydia and find it difficult to talk to a partner or friends, don’t be afraid to discuss how you feel with the staff at the clinic or general practice.

Will I have to pay for treatment?

Treatment is free through NHS services and the National Chlamydia Screening Programme.

What's the treatment for chlamydia?

Chlamydia is treated with antibiotics. If you take the treatment according to instructions, it’s over 95% effective at treating chlamydia.

• You’ll be given a course of antibiotics for 3 or 7 days or sometimes up to two weeks.
• If there’s a high chance you have chlamydia, treatment may be started before the results of the test are back. You’ll always be given treatment if a sexual partner is found to have chlamydia.
• You may also need other treatment if complications have occurred.
• Tell the doctor or nurse if you’re pregnant, or think you might be, or you’re breastfeeding. This may affect the type of antibiotic you’re given.
• Complementary therapies (treatments outside of mainstream healthcare) can’t cure chlamydia.

When will the signs and symptoms go away?

You should notice an improvement quite quickly after having treatment.

• Discharge or pain when you urinate should improve within a week.
• Bleeding between periods or heavier periods should improve by your next period.
• Pelvic pain and pain in the testicles should start to improve quickly but may take up to two weeks to go away.

If you have pelvic pain or painful sex that doesn’t improve, see your doctor or nurse as it may be necessary to have some further treatment or investigate other possible causes of the pain.

Do I need to have a test to check that the chlamydia has gone?

If you take the treatment according to the instructions, you won’t usually need a test to check the chlamydia has gone.

If you’re aged under 25, you should be offered a repeat test 3 months after finishing the treatment. This is because you’re at a higher risk of getting chlamydia again.

Whatever your age, you may need a repeat test or more treatment if:

• you think you’ve come into contact with chlamydia again
• you had sex without a condom with a partner before the treatment for both of you was finished (see How soon can I have sex again? in the Other things to know section)
• you didn’t complete the treatment or didn’t take it according to the instructions
• the signs and symptoms don’t go away (see above, When will the signs and symptoms go away?)
• your test was negative but you develop signs or symptoms of chlamydia (see Signs and symptoms)
• you’re pregnant.

A repeat test can be done 5–6 weeks after the first test.

If the chlamydia was in your rectum (back passage), you may need another test around 3 weeks after finishing the treatment. Your doctor, nurse or clinic will let you know if you need another test.

You can go back to the doctor, nurse or clinic if you have any questions or need advice on how to protect yourself from infection in the future.

What happens if chlamydia isn't treated?

Only some people who have chlamydia will have complications. If chlamydia is treated early, it’s unlikely to cause any long-term problems. But, without proper treatment, the infection can spread to other parts of the body. The more times you have chlamydia the more likely you are to get complications.

• If you have a vulva, chlamydia can spread to other reproductive organs causing pelvic inflammatory disease (PID). This can lead to long-term pelvic pain, blocked fallopian tubes, infertility and ectopic pregnancy (when the pregnancy develops outside the uterus, usually in a fallopian tube).
• In people with a vulva, chlamydia can also cause pain and inflammation around the liver, though this is rare. This usually gets better with the correct antibiotic treatment.
• If you have a penis, chlamydia can lead to infection in the testicles. If this isn’t treated, there’s a possibility it could affect your fertility but more research is needed to understand how likely this is.
• Rarely, chlamydia can lead to inflammation of the joints. This is known as Sexually Acquired Reactive Arthritis (SARA) and is sometimes accompanied by inflammation (pain, redness or swelling) of the urethra (tube where urine comes out) and the eye. This is more likely to occur in people with a penis than people with a vulva.

Can chlamydia go away without treatment?

It can, but it can take a long time. If you delay seeking treatment you risk the infection causing long-term damage and you may still be able to pass the infection on to someone else.

If the test shows that you have chlamydia then it’s very important that your current sexual partner(s) and any other recent partners are also tested and treated as they may have the infection without knowing it. This will help to stop them re-infecting you or passing chlamydia on to anyone else.

You may be given a contact slip to send or give to your partner(s) or, with your permission, the clinic can do this for you. This is called partner notification. It can sometimes be done by text message. The message or contact slip will say that they may’ve been exposed to a sexually transmitted infection and suggest they go for a check-up. It may or may not say what the infection is. It won’t have your name on it, so your confidentiality is protected.

You’re strongly advised to tell your partner(s), but it isn’t compulsory. The staff at the clinic or general practice can discuss with you which of your sexual partners may need to be tested.

How soon can I have sex again?

Don’t have oral, vaginal or anal sex, or use sex toys, until you and your partner(s) have both finished the treatment and any symptoms have gone. This is to help prevent you being re-infected or passing the infection on to someone else.

If you’re given antibiotic treatment called azithromycin, you’ll still need to avoid sex for seven days after starting the treatment as that’s how long it takes to work.

How will I know if the chlamydia has affected my fertility?

Chlamydia is just one of many factors that can affect your fertility. Most people who’ve had chlamydia won’t become infertile or have an ectopic pregnancy (see What happens if chlamydia isn’t treated? in the Treatment section). If you’ve had chlamydia you won’t normally be offered any routine tests to see if you’re fertile unless you or a partner are having difficulty getting pregnant. If you’re concerned, talk to your doctor or practice nurse.

What happens if I get chlamydia when I'm pregnant?

• Chlamydia during pregnancy has been associated in very rare cases with problems such as premature (early) birth, and infection of the uterus (womb) lining after the birth.
• It can be passed to the baby during the birth and (less commonly) before the baby is born. This can cause inflammation and discharge in the baby’s eye(s) (conjunctivitis) and/or pneumonia.
• You may be offered a chlamydia test as part of your antenatal care.
• Chlamydia can be treated with antibiotics when you’re pregnant and when you’re breastfeeding. The antibiotics won’t harm the baby, but do tell the doctor or nurse that you’re pregnant or breastfeeding.
• You’ll be advised to have another test after you complete your treatment.

Does chlamydia cause cervical cancer?

No, chlamydia doesn't cause cervical cancer.

It's possible to get a sexually transmitted infection (STI) by having sex with someone who has an STI, even if they have no symptoms.

The following measures will help protect you from most STIs including chlamydia, gonorrhoea and HIV.

If you have an STI, they'll also help prevent you from passing it on to someone:

• Use condoms (external/male or internal/female) every time you have vaginal or anal sex.
• If you have oral sex (going down, giving head), use a condom to cover the penis, or a dam (latex or plastic square) to cover the vulva or anus.
• Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.
• How to use condoms.