Urogenital chlamydia | That's what we need to know

18.05.2022

Chlamydia Is a common sexually transmitted disease caused by bacteria With Chlamydia trachomatis. It can cause Cervicitis, urethritis და Proctitis.

Table of Contents

In women, these infections can cause:

Pelvic inflammatory disease
Infertility caused by tube factor
Ectopic pregnancy
Chronic pelvic pain

Many cases of chlamydia are difficult to record because most infected people have no symptoms and do not seek testing. Chlamydia is most common in young people (two-thirds of infections occur in young people aged 15-24).

How do people get chlamydia?

Chlamydia is spread through vaginal, anal, or oral sexually transmitted infections. Sperm is not necessary to get or spread an infection.

Infected pregnant women can pass chlamydia to their baby during childbirth. This can lead to neonatal conjunctivitis or pneumonia. Rectal or genital infection in newborns may persist for a year or more.

If you have sex with a person with chlamydia, a person with chlamydia who is being treated can become infected again.

Who is at risk for developing chlamydia?

At risk for developing chlamydia are sexually active people who may become infected during vaginal, anal, or oral sex without a condom with a partner who is infected with chlamydia.

Teenage girls and young women may have cervical ectopy, which may increase their susceptibility to chlamydial infection.

Risk factors

Sexually active persons under 25 years of age
Having several sexual partners
Do not use a condom constantly
History of sexually transmitted infection

Symptoms of chlamydia

Some refer to chlamydia as a "silent" infection because most people with the infection have no symptoms or abnormal physical examination results. Studies have shown that about 10% of men and 5-30% of women with confirmed infection develop symptoms.

Signs and symptoms of an infection may include:

Painful urination
Vaginal discharge in women
Discharge from the penis in men
Painful sexual intercourse in women
Bleeding between menstruation and after sex in women
Testicular pain in men

In women, the bacteria initially damage the cervix. This can lead to Cervicitis Signs and symptoms (e.g. mucosal-purulent endocervical discharge, easily induced endocervical bleeding). Bacteria can also infect the urethra, which can cause it Urethritisს Signs and symptoms (eg, pyuria, dysuria, frequent urination). The infection can spread from the cervix to the upper reproductive tract (i.e. the uterus and fallopian tubes) and cause Pelvic inflammatory disease (PID), which may be asymptomatic ("subclinical PID") or with typical symptoms of acute abdominal and / or pelvic pain. Examination may reveal signs of cervical movement and hypersensitivity of the uterus.

Men with symptoms usually have urethritis, mucous or watery urethral discharge, and dysuria. Some men develop epididymitis (with or without symptomatic urethritis) with unilateral testicular pain, hypersensitivity, and edema.

Chlamydia can infect the rectum in both men and women. It can occur directly - through anal sex, or by spreading it from the cervix and vagina in women. Although these infections are often asymptomatic, they can cause symptoms of proctitis (eg, rectal pain, discharge, and / or bleeding).

Conjunctivitis can develop in both men and women due to contact with infected genital secretions.

Although chlamydia can also be spread in the mouth during oral sex, there are usually no symptoms at this time.

Complications of chlamydia

The primary damage caused by chlamydia is often overlooked. However, infections can lead to serious health problems with both short-term and long-term consequences.

If left untreated, chlamydia can spread to the uterus or fallopian tubes and cause Pelvic inflammatory disease (PID). Symptomatic PID occurs in approximately 10-15% of women who do not receive treatment. Both acute and subclinical PID can cause Damage to the fallopian tubes, uterus, and surrounding tissues. Injury can cause Chronic pelvic pain, tube-induced infertility და Potentially fatal ectopic pregnancy.

It develops in some patients with PID Perihepatitis, or "Fitz-Hugh-Curtis Syndrome." This syndrome involves inflammation of the liver capsule and surrounding peritoneum, which can cause pain in the right upper quadrant of the abdomen.

Untreated chlamydia in pregnant women can cause Premature birth, neonatal ophthalmia (conjunctivitis) და Neonatal pneumonia.

In men and women it can develop with or without symptoms after infection Reactive arthritis.

Untreated chlamydia can increase a person's chances of getting or transmitting HIV (human immunodeficiency virus).

How does chlamydia affect a pregnant woman and her baby?

Untreated chlamydia in infants can cause:

Premature birth
Neonatal ophthalmia (conjunctivitis)
Neonatal pneumonia

Screening and treating chlamydia in pregnant women is the best way to prevent the disease in infants. During the first prenatal visit and during the third trimester, screening is recommended:

In all pregnant women under 25 years of age
All pregnant women over the age of 25 who are at increased risk of developing chlamydia (e.g., who have a new or more than one sexual partner).

Who needs a test for chlamydia?

Anyone who has the following genital symptoms:

Discharge
Burning sensation when urinating
Unusual ulcers, or rashes

Anyone who has had oral, anal, or vaginal sexual contact with a partner who has recently been diagnosed with a sexually transmitted disease.

Because chlamydia usually has no symptoms, Screening is required To detect most infections. Screening programs can reduce the incidence of adverse outcomes in women.

Men who have sex with men (including those living with HIV) should have more frequent screening for chlamydia at intervals of 3 to 6 months if the risk factors persist or if they or their sexual partners have multiple partners.

All sexually active people should be tested for chlamydia at the initial visit for HIV.

Diagnosis of chlamydia

Chlamydia can be diagnosed by determining the DNA of Chlamydia Trachomatis by polymerase chain reaction (PCR):

It is advisable for diagnostics

In men The first part of the morning urine is using. This is the most optimal material in which case the diagnostic sensitivity reaches 85% -95%.
In women Urogenital smear Use. The use of the first part of the urine has a lower diagnostic sensitivity (about 80-90%) than in men, so in the case of women urogenital smear is recognized as the most optimal material for testing. The study of the first part of the urine in women can be used in situations where it is difficult to take a smear from the vagina and cervix (for example, in pregnant women) or in the face of a cystitis clinic (including chronic). It is the most optimal time to examine women The fourth week from the first day of the last menstrual period.

Treatment of chlamydia

Chlamydia is treated with antibiotics.

In most cases, the infection disappears in 1-2 weeks. You should abstain from sexual contact during this time. Your sexual partner or partners also need treatment, even if they have no signs or symptoms.

The presence of chlamydia or its treatment in the past does not rule out the possibility of re-infection with chlamydia.

Prevention

To prevent chlamydial infection it is advisable to:

Use a condom every time you have sex. Condoms reduce but do not rule out the risk of infection.
Limit the number of your sexual partners. Having multiple sexual partners puts you at high risk for infection with chlamydia and other sexually transmitted infections.
Perform regular screening. If you are sexually active, especially if you have multiple partners, get information from your doctor about how often you should be screened for chlamydia and other sexually transmitted infections.
Avoid vaginal douching, which reduces the amount of good bacteria in the vagina, which can increase the risk of infection.

If you suspect chlamydia (for diagnostics), if you are infected with chlamydia trachomatis, if you have an infection (for monitoring) or if you want screening (for prevention), Laboratory "Synevo" offers the following studies: