It’s that time of year again. We all eat too much, drink too much, and get a bit silly under mistletoe. Not to mention those office parties! Nudge – wink! No wonder – and yes this is true – there is an increase in the numbers of sexually transmitted infections in January & February.
Chlamydia trachomatis is the most common bacterial STI that we see in the sexual health clinic. Read on and discover a lot of facts about treating chlamydia you probably never knew …
1. Chlamydia is a serious infection. If not promptly detected and treated, it may cause male and female infertility, and ectopic pregnancy, which can be life threatening.
2. A positive chlamydia test does not always mean you actually have it. The test used for chlamydia is called a DNA amplification test. The test is extremely sensitive. It may be positive with only tiny amounts of DNA present. This could be either by contamination for example from the glove of the doctor or nurse who took the swab, or because something other than chlamydia has interlinked with the DNA segment, and given a positive result – although this is probably very rare. In practical terms, when running sexual health services, a positive result has to be regarded as a true positive and should always be properly treated.
3. It takes 7 days after unprotected sex for a chlamydia test to become positive, so don’t get tested too early - you may get a false negative result.
4. If you have no symptoms, a urine test or a self taken swab are both equally useful as screening tests. But for example, if you are a woman with urinary symptoms, a chlamydia urine test is probably preferable to a vaginal swab.
5. A vaginal swab you take yourself, is actually a better screening swab than one taken by a doctor or nurse! Probably because you can press harder, whereas the nurse or doctor is too gentle!
6. If you do a urine test you must not have passed urine for at least one hour before you do the specimen. The cells that line the neck of the bladder are actually being tested. When you pass urine, you pee all these cells away. It takes a minimum of 1 hour for enough cells to build up again for the test to be reliably undertaken.
7. Chlamydia may be treated with either doxycycline 100mg twice a day for 7 days, or a single 1g dose of azithromycin. There are pros and cons with each type of treatment. Sexual health specialists tend to favour 7 days of doxycycline, because; this is a longer acting regime, it is effective at other sites such as the throat and the rectum and because of concerns about possible antibiotic resistance.
8. Your most recent partner, and any other partners from the last three months should all be treated too. This is irrespective of whether they test positive or negative.
9. When being treated you and your partner should take your antibiotics at the same time and not have sex on treatment, not even with a condom.
10. If you are treated with anything other than doxycycline or azithromycin, you should have a repeat test to check the infection has cleared. But – you need to wait 5 weeks from starting treatment to do this, as the test may give false positive results if repeated too early.
11. Doxycycline should not be taken in pregnancy.
12. A 7 day course of doxycycline is for those who test positive but have no symptoms. If you have symptoms such as abdominal or testicular pain, you should have a minimum of a 2 week course of antibiotics.
13. If you do get chlamydia, try hard not to get it again! Long term complications are more common in those who have repeated episodes of infection.
14. Yes chlamydia can cause conjunctivitis and may give you a sore, sticky eye!
15. There is a blood test for chlamydia antibodies. However this is not very useful as it gives no indication as to when you had the infection. This test is sometimes used in infertility clinics if a woman is found to have blocked tubes.
16. Most women with tubal blockage from chlamydia had no symptoms at the time of their infection and were unaware. This is why young people really must have regular screening.
17. Screening is recommended for all young people under 25, every time they have a new partner, or if they have any symptoms such as pain passing urine, abnormal vaginal bleeding/discharge or abdominal pain/painful sex. Screening kits are available in GP surgeries, pharmacies, in sexual health clinics and can be obtained online and sent back in the post.
18. Chlamydia can be detected in the back of the throat, usually from oral sex.
19. Chlamydia can cause Sexually Acquired Reactive Arthritis, SARA, which can be very difficult to treat.
20. Consistent, careful use of condoms is the only way to protect yourself from becoming infected. But even using condoms does not 100% guarantee you will not become infected. You should still be regularly screened.
For your nearest Sexual Health Clinic, simply put your post code into the search bar, at https://www.nhs.uk/Service-Search/Sexual-health-services/LocationSearch/1847
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2. Advances in Sampling and Screening for Chlamydia
Jane S Hocking; Rebecca Guy; Jennifer Walker; Sepehr N Tabrizi
Future Microbiol. 2013;8(3):367-386.
3. NHS Choices Chlamydia
4. Self-taking vaginal sample best test for chlamydia and gonorrhoea in women
http://stirf.org/2013/01/14/self-taking-vaginal-sample-best-test-for-chlamydia-and-gonorrhoea-in-women/ posted on 14th January 2013 by Mohsen Shahmanesh
5. Horner, P. J., & Saunders, J. (2017). Should Azithromycin 1g be abandoned as a treatment for bacterial sexually transmitted infections? The case for and against. Sexually Transmitted Infections, 93(2), 85-87. DOI: 10.1136/sextrans-2015-052414