Chlamydia: the disease that hides

You might think chlamydia is a rare sexually transmitted disease (STD) that you don’t need to worry about. Or that it has minor symptoms. Both these assumptions are wrong. Turns out chlamydia is the most commonly reported STD. While both women and men can indeed be asymptomatic (without symptoms), chlamydia can cause serious problems such as infertility, painful urination, fever, genital discharges and pink-eye. Specifically in women, chlamydia can lead to ectopic pregnancy, pelvic inflammatory disease, vaginal bleeding, miscarriage, and the risk of passing the infection to an unborn baby who might develop pneumonia. In men, it can lead to swollen and painful testicles as well as arthritis. [i] [ii]

What is chlamydia and should I be concerned about it?

Chlamydia trachomatis is a bacterium with unusual properties that make it difficult to detect. Even though it was identified in the 1950s, chlamydia could not be easily diagnosed until the 1980s. 80% of infected women can be asymptomatic along with 50% of men, which is why the disease can go undetected[iii].

Highest infection rates are among women: in 2018, 3.3% of 15 to 19-year olds and 4% of 20 to 24-year-olds among those tested were positive. For these reasons, the CDC recommends that all sexually active women and girls younger than 25 should be screened annually for both chlamydia and gonorrhea. Because of relatively high rates among sexually active gay and bisexual men, the CDC recommends annual screening for syphilis, chlamydia, and gonorrhea for this population as well.[iv]

A specialized test using a urine sample called a nucleic acid amplification test (NAAT) is typically employed to screen for chlamydia.

Chlamydia can be transmitted through vaginal, rectal and oral sex, or through any direct contact with infected tissue (including on objects or between two women). Past infection does not confer immunity (i.e. you can get it again). It can remain hidden for long periods and can lead to the serious symptoms already mentioned.

So you may need to be concerned about chlamydia for your own sake or that of a loved one.

What does chlamydia have to do with hormones?

There are many reasons for this article, which is part of a series on hormones and endocrine system problems. First, chlamydia is more common than many people realize. Second, it is easily transmissible. Third, it can be asymptomatic, and without screening can remain unnoticed. But chlamydia symptoms can be mistakenly attributed to other causes, including hormones.

For example, infertility in both women and men can result from many factors, chlamydia is one of them.

For women: before testing, some chlamydia symptoms can be misinterpreted as signs of pregnancy. Ectopic pregnancy in particular has several potential causes, including chlamydia. Vaginal discharge is often attributed to a fungal/yeast infection and/or high blood sugar (an endocrine issue), yet it can also be caused by chlamydia. Finally, endometriosis and chronic pelvic pain can be difficult to diagnose and are often caused by hormones, but symptoms might also be the result of chlamydia.

Enlarged prostate, a relatively common condition among men, as well as pain and swelling in the testicles, can be due to chlamydia.

Treating chlamydia

Chlamydia is typically addressed with antibiotics, however, in order to prevent re-infection, sexual partners should be treated as well. Special attention needs to be paid to adolescents, who have a high rate of infection but low compliance with treatment, frequently due to wanting to keep information from their parents. For this reason, adolescents might be given single-dose in-office treatment.

Those testing positive for chlamydia are advised to abstain from sexual contact with their current partner in order to prevent re-infection.

For women who develop pelvic inflammatory disease, the most serious consequence of untreated chlamydia, hospitalization may be necessary.  

Prevention

While chlamydia is treatable, for those who are sexually active and potentially exposed, the best offense is a good defense, beginning with avoidance of sexual activity until after treatment is finished. Then, as future prevention:

·        Use a condom when engaging in sex (vaginal, oral or anal)

·        Use a “dam” (a piece of thin, soft plastic or latex) to cover the female genitals during oral sex or when rubbing female genitals together

·        Don’t handle objects that may have been exposed to the body fluids of someone who might be infected [v]

The takeaways

The main takeaway from this article should be increased awareness of a disease that can have tragic consequences. The second is to be on the lookout for symptoms that might be masquerading as hormonal issues. Finally, if you think there is a possibility you or a loved one might be infected with chlamydia, please make an appointment as soon as possible with a primary care provider, or visit a community health clinic.

To learn more about how I could help you with your hormonal problems, call me for a free 15-minute consultation or schedule one on the online scheduler.

[i] “Chlamydia”, https://emedicine.medscape.com/article/214823-overview

[ii] Mohseni, M, S Sung V Takov (2020) “Chlamydia” Stat Pearls: Stat Pearls Publishing   https://www.ncbi.nlm.nih.gov/books/NBK537286/

[iii] CDC “Chlamydia: clinical presentation: https://emedicine.medscape.com/article/214823-clinical

[iv] CDC (2021) “Which STD tests should I get?”: https://www.cdc.gov/std/prevention/screeningreccs.htm

[v] NHS “Chlamydia”, https://www.nhs.uk/conditions/chlamydia/