Chlamydia infections in women

Definition

Chlamydia is a sexually transmitted disease. This article discusses chlamydia infections in women.

See also:

• Chlamydia
• Chlamydial urethritis

Causes, incidence, and risk factors

Chlamydia is caused by the bacteria Chlamydia trachomatis.

Different strains of chlamydia cause genital, eye, lymph node, and respiratory infections.

A baby born to a woman with a chlamydia infection of the cervix may develop eye or lung infections.

Chlamydia is transmitted through sexual activity. Sexually active individuals and individuals with multiple partners are at highest risk for chlamydia infections.

Symptoms

• Abdominal pain
• Burning on urination
• Painful intercourse
• Vaginal discharge or bleeding after intercourse

Note: Some women with chlamydia have no symptoms at all. Only some women will have symptoms. Therefore, screening sexually active women for chlamydia is necessary to diagnose and treat the condition in women who do not have symptoms.

Signs and tests

Diagnosing a chlamydia infection in a woman involves taking a sample of cervical secretions and sending it to a lab for an endocervical culture or a similar test called PCR.

Chlamydia infection can be diagnosed with a urine test.

Endocervical culture for gonorrhea may also be done.

Treatment

Chlamydia can be treated with a variety of antibiotics, including azithromycin, tetracyclines, quinolones, and erythromycin. Erythromycin and azithromycin are safe in pregnant women.

Both sexual partners must be treated to prevent passing the infection back and forth between them, even though both may not have symptoms.

Since gonorrhea often occurs along with chlamydia, treatment for gonorrhea is often given at the same time.

Expectations (prognosis)

Antibiotic treatment is usually successful. Reinfection may occur if you do not take your medicine as directed, or if your sexual partner is not treated.

Complications

Chlamydia infections in women may lead to inflammation of the cervix.

An untreated chlamydia infection may spread to the uterus or the fallopian tubes, causing salpingitis or pelvic inflammatory disease. These conditions can lead to infertility and increase the risk of ectopic pregnancy.

If a women is infected with chlamydia while pregnant, the infection can cause premature labor and delivery. It may also cause infection in the uterus after delivery (late postpartum endometritis). In addition, the infant may develop chlamydia-related conjunctivitis (eye infection) and pneumonia.

Calling your health care provider

Call for an appointment with your health care provider if symptoms of chlamydia occur.

Prevention

All sexually active women aged 20 - 25 should be screened yearly for chlamydia. All women with new sexual partners or multiple partners should also be screened.

A mutually monogamous sexual relationship with an uninfected partner is one way to avoid this infection. The proper use of condoms during intercourse usually prevents infection.

References

Centers for Disease Control and Prevention (CDC). Update to sexually transmitted diseases guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep. 2007;56:332-336.