SoftCare Clinic

Sexually Transmitted Infections

Chlamydia

Chlamydia: Gynecologist Consultation

Infection card

Loading…

  • From left to right: sample type · testing window (days) · cleared by treatment (pill) or virus persists (virus) · partner treatment · follow-up after 3 months · pregnancy screening · at the clinic or referral.

Window days are approximate; the doctor decides according to the test type.

Symptoms

The most common symptoms in women:

  • Abnormal vaginal discharge
  • Burning when urinating
  • Pain during or after sex
  • Bleeding between periods or after sex
  • Lower abdominal or groin pain

In men:

  • Clear or cloudy discharge from the urethra
  • Burning when urinating
  • Pain or swelling in the testicles (less common)

Rectal infection may cause pain, discharge or bleeding. Throat infection is usually symptom-free. About 70–80% of women and a large proportion of men have no symptoms at all. This is why screening matters.

Diagnosis

The most reliable diagnostic method is the nucleic acid amplification test (NAAT / PCR). In women a vaginal swab or urine sample is used; in men urine or a urethral swab. If there is a history of anal or oral contact, a sample may also be taken from that site. A urine sample is practical, but swab samples are more sensitive at some sites.

If the test is positive, testing for gonorrhea, syphilis and HIV is also recommended. More than one agent may be present at the same time. If pregnancy is suspected, a pregnancy test is done first.

Treatment

Chlamydia is treated with antibiotics. In current guidelines (CDC and similar), the first choice is doxycycline 100 mg twice daily for 7 days. Alternatively, a single dose of azithromycin or levofloxacin for 7 days may be used. Doxycycline is not preferred in pregnancy; azithromycin or amoxicillin are discussed instead.

Avoid sex during treatment and for at least 7 days after it is completed. Sexual partners from the last 60 days should also be tested and treated if needed. If the partner is not treated, the infection comes back. Retesting is recommended about 3 months after the end of treatment; early reinfection is common.

Once treatment is completed, the infection usually clears. However, if tubal damage has occurred, antibiotics cannot reverse it. This is why early diagnosis is important.

Complications

Untreated or recurrent chlamydia infection can increase these risks in women:

  • Pelvic inflammatory disease (inflammation affecting the uterus, tubes and ovaries)
  • Tubal damage and infertility
  • Increased risk of ectopic pregnancy
  • Chronic pelvic pain

In men, epididymitis and, rarely, urethral stricture may occur. If untreated in pregnancy, the newborn may develop conjunctivitis or pneumonia.

The risk of complications is higher especially in infections that cause symptoms and are not treated. Infections without symptoms also carry risk; this is why screening and early treatment protect reproductive health.

Chlamydia and PID: Ultrasound Examination
Ultrasound examination: with pelvic pain and fever, an assessment for pelvic inflammatory disease is carried out.

Who should be screened

Annual chlamydia screening is recommended for sexually active women under 25. At 25 and over, screening is considered if there is a new partner, more than one partner, an STI history in the partner or a previous STI. A risk assessment is also done in pregnancy. Men are tested if they have symptoms or a positive partner.

Screening can be done even without symptoms. Condom use reduces the risk but does not eliminate it; regular screening is still discussed.

Prevention

  • Using a condom every time you have sex
  • Number of partners and risk assessment
  • Regular screening (especially under 25)
  • Partner treatment and avoiding sex during treatment
  • Assessment before planning a pregnancy

Having had chlamydia once does not give immunity. Reinfection is possible.

Our approach at SoftCare

At SoftCare Clinic, chlamydia assessment begins with a gynaecological history and examination. If there are symptoms or screening is needed, a vaginal swab or urine sample is taken; NAAT (PCR) is run at a partner laboratory. Tests for gonorrhea and other STIs can be planned at the same time.

If the result is positive, antibiotic treatment is started, informing the partner is discussed and a follow-up test after 3 months is recommended. If there is pelvic pain, fever or heavy discharge, PID is assessed. If pregnancy is suspected or confirmed, the choice of treatment is adjusted accordingly. HIV treatment is not provided at the clinic; a referral is arranged if needed.

Appointments: +90 212 241 30 10 · softcareclinic.com

References

  • CDC Chlamydia page and 2021 STI Treatment Guidelines
  • WHO Chlamydia fact sheet
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü (Ministry of Health of Türkiye, General Directorate of Public Health) – Klamidya
  • USPSTF screening recommendation
  • Workowski et al. MMWR 2021
  • Merck Manual
  • Hoenderboom et al. (association of PID, ectopic pregnancy and infertility risk)

Listing a source does not mean SoftCare wrote that text.

Medically reviewed by Op. Dr. Şükrü Sanus, Obstetrician & Gynecologist · Last medical review: