BN Doctors’ Lounge: Chlamydia

“Doctor, so what are you saying? That I can never have kids of my own? Doctor, no, please, do something, please!!!”
So sad. I slip into the doldrums each time I have to have this conversation with patients with blocked fallopian tubes or dead and immotile sperm cells. The culprit? Chlamydia!

According to the Centre for Disease Control and Prevention (CDC), 1 in 2 sexually active adults will have had a Sexually Transmitted Infection (STI) by age 25. Chlamydia is currently the most common STI, probably due to the fact that it often presents with no symptoms. In the light of the HIV/AIDS scourge, this very common and dangerous disease has gone ignored; secretly invading reproductive organs and snatching kids from hopeful would- have- been parents.

What is Chlamydia?
It is an STI caused by a tiny bacterium chlamydia trachomatis, which was originally identified as a virus.
In women, chlamydia usually affects the cervix and uterus (the womb). In men, it usually affects the urethra in the penis. The infection is acquired through unprotected sexual intercourse with an infected person, transmitted through all sexual routes; vaginal, oral, anal.
If left untreated, chlamydia causes long-term complications in men, like inflammation of the fine tubes that take sperm from the testicles to the penis. It can result in blockage of these tubes with scar tissue formation, causing a reduction in sperm count, motility and morphology.
In women, the bacterium can creep upwards to the uterus and fallopian tubes, causing permanent damage to them over many months or years. Long-term chlamydial infection can cause the tubes to gradually scar and become blocked, inhibiting fertilization. Chlamydia results in Pelvic Inflammatory Disease (PID) which is a grave concern not only because of its effect on fertility but also due to the risk of a tubal or ectopic pregnancy.

Symptoms of Chlamydia
Chlamydia is known as a ‘silent’ infection because most infected people have no symptoms and it’s quite unnerving to think that there’s a disease out there with no ‘warning signs’. It’s even more disturbing to know that it is the most common STI (can’t say this enough), affecting as much as 1 in 14 sexually active adults.
In a lucky few, symptoms do occur (lucky because at least they get prompted to seek treatment), however, they may not appear until several weeks after exposure.

Symptoms in Women
• Vaginal discharge. This is due to the cervix becoming inflamed.
• Pain or burning on urination
• Vaginal bleeding or spotting between periods. In particular, bleeding after sex.
• Pain or discomfort in the lower abdomen (pelvic area), especially during sex.

Symptoms in Men
• Pain or burning on urination
• Slight discharge from the penis
• Pain or discomfort at the tip of the penis.

How Can the Doctor Be Certain I Have Chlamydia?
Chlamydia can be confirmed by a swab taken from the cervix (neck of the womb) in women and from the urethra in men and sent to the laboratory for testing. Alternatively, you may be asked to provide a urine sample. In patients who have had anal or oral sex, a rectal or throat swab is also taken. However, treatment may be started before testing in cases of strong clinical suspicion. Also, other STIs may be tested for as well.

Can it Be Treated?
Chlamydia is easily treated with a simple course of antibiotics, and the earlier the condition is detected, the easier it is to treat. Repeat infection with chlamydia is common. Persons whose sexual partners have not been appropriately treated are at high risk for re-infection therefore contact tracing is usually done and all sexual consorts are treated. Having multiple chlamydial infections increases a woman’s risk of serious reproductive health complications, including PID and ectopic pregnancy. Women and men with chlamydia should be re-tested about three months after treatment of an initial infection.

Treatment Pitfalls
• Not completing the dose
• Unprotected intercourse during treatment
• Unprotected intercourse with untreated partner
• Drug interactions (tell your doctor about other meds you might be taking).

Preventing Chlamydia
Barrier contraception (the most common of which is the latex male condom) and regular testing are the focal points in prevention.
‘Embarrassment’ (with regards to testing) is right up there with ignorance as one of the biggest causes of the spread of STIs. These days with discrete home test kits for most STIs, many have run out of excuses not to take their sexual health seriously.

In a Nutshell
If you are having unprotected sex, you are at risk! The one person you can vouch for is yourself. So, be it within the confines of a loving monogamous relationship, or not, you must get tested.
Chlamydia is unarguably the greatest threat to human fertility. Many people carry on the infection from previous relationships several years before, so a positive chlamydia test doesn’t mean anyone’s cheating, the bug might have been hanging in there for a while. It is easily treatable with a simple course of antibiotics. So, have a nice chat with your partner, and go get tested today (brave it, chest the yawa).

Did You Know?
Chlamydia can infect babies born to infected mothers causing a nasty discharge of pus from their eyes about a week after birth, which if untreated can go on to become pneumonia. The bacterium also causes trachoma, a common cause of blindness.

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Annette Bazuaye is a Medical practitioner, writer, researcher and UN Millenium Development Ambassador. She holds a Bachelor of Medicine, Bachelor of Surgery from the University of Benin, and a Master of Science in Global Health from the University of Oxford. She is committed to preventive medicine, health literacy and community development.