Chlamydia, like other sexually transmitted infections, has long been stigmatized, with discussions about it relegated to traumatic health class lectures (Mean Girls, anyone?) and the butt of sexist jokes.
But for all the shame surrounding it, chlamydia is nothing if not common. With nearly 2 million cases reported to the CDC in 2019 alone, it’s the most common bacterial STI worldwide, not to mention in the US, according to the CDC and the World Health Organization. It’s for perhaps all these reasons that pop culture feels comfortable referring to the STI — from episodes of Sex and the City to full-fledged plotlines in Netflix’s Lovesick.
Though very contagious, chlamydia is easily curable (which could be why mass media finds it more approachable than others that aren’t such as, say, HIV or herpes). So while a chlamydia diagnosis can be upsetting, there’s no need to panic; millions of people have had chlamydia and lived to tell the tale. Not to mention, this infection (or any other STI, for that matter) says nothing about who you are as a person.
Here's everything you need to know about chlamydia symptoms, treatment, and more.
What Is Chlamydia, Exactly?
Chlamydia is an infection caused by the chlamydia trachomatis bacteria, which tends to be passed with intimate contact and is thus considered a sexually transmitted infection,” explains Betsy Greenleaf, D.O., FACOG, advisor for pH-D Feminine Health, a sexual health company. (Also read: What’s the Difference Between an STI and STD?)
Chlamydia can be spread through sexual activity or any kind of contact that involves an “opening in the skin or mucous membranes… inside the mouth, or the mucous membranes of the vagina or the genitals,” says Renita White, M.D., board-certified ob-gyn in Atlanta, Georgia. This means chlamydia can be transmitted through vaginal, anal, and oral sex, even if condoms are used (since not all skin is covered by the condom).
This means it’s also possible to pass chlamydia through a used, unclean sex toy, explains Tamika K. Cross, M.D., FACOG, advisor for pH-D Feminine Health. (If you’re sharing a sex toy or using it with partners, always use condoms or be sure to clean your sex toy thoroughly between each partner and use.)
“Pregnant moms can spread [chlamydia] to their newborn, and if bacteria enters the eyes, this can cause conjunctivitis,” says Emily Rymland, D.N.P., F.N.P.-C., director of clinical services for telehealth provider Nurx.
To put it in perspective, remember that "the term 'infection' represents the fact that foreign bacteria have 'infected' the body," says Dr. Greenleaf. "There are other infectious diseases such as strep throat that can be passed with kissing or close contact, but we don't consider strep an STI."
The Most Common Chlamydia Symptoms
Here’s where things get tricky; chlamydia is more likely to be asymptomatic compared to many other common STIs, which is how it garnered its nickname as the “silent” infection. Only 10 percent of men and somewhere between 5-30 percent of women with a confirmed chlamydia infection develop symptoms, according to the CDC.
“Part of the reason why it’s so common is that most people who have [chlamydia] don’t have any symptoms at all,” says Julie Dombrowski, M.D., M.P.H., associate professor in the division of allergy and infectious diseases at the University of Washington and deputy director for clinical services at the Public Health Seattle & King County STD Clinic. Because it’s so often asymptomatic, you can pass the infection to others without knowing you have it.
People with vaginas are more likely to find out they're infected because of regular chlamydia screenings (such as during an annual ob-gyn appointment); therefore, more cases are reported in womxn simply due to the lack of screening in people with penises, explains Rymland.
For the small percentage of people who aren’t asymptomatic, the most common symptoms of chlamydia are:
Though rare, other symptoms can include:
In some cases, chlamydia might show up in the mouth or throat, causing a sore or scratchy throat, says Sharon Sung, M.D., board-certified ob-gyn in Lansing, Michigan. In even rarer cases (mostly when babies are born to birthing parents with chlamydia), it can show up in the eyes, causing irritation, says Dr. Sung. It can happen with adults (for example, if you touch someone’s genitals who has chlamydia and then touch your eye), but “it’s pretty darn rare,” says Dr. Dombrowski. (See: Yep, It’s Possible to Get an STD In Your Eye)
Because chlamydia is largely asymptomatic, it often goes untreated, which can lead to bigger problems down the line, especially for people with uteruses. (So, no, chlamydia will not go away on its own.)
“In 1 in 9 women who get chlamydia, the bacteria will cause an upper genital tract disease,” says Dr. Dombrowski. “That is what’s called pelvic inflammatory disease.” PID manifests with symptoms like abdominal and pelvic pain, plus fevers and chills, and can cause scarring in the fallopian tubes, which may lead to infertility, says Dr. Sung. PID also increases the risk of ectopic pregnancy, a dangerous condition in which an embryo implants in the fallopian tube and is unable to make its way to the uterus, where a healthy pregnancy develops, explains Dr. White. “Women may not have gotten treated for chlamydia, or didn’t know if they’re in the group of people who were without symptoms; then, when they try to get pregnant, their tubes are scarred or blocked,” says Dr. White.
How to Test for Chlamydia
Great news: Chlamydia testing is easy and painless. You can be tested for chlamydia with a simple urine test or a quick swab of the vaginal mucosa, which can be done simultaneously with your pap smear, says Dr. Greenleaf. (It's not automatically included, rather, you need to ask your doc for the test.) Your doctor will likely send your sample off to a lab where technicians can test for the presence of the chlamydia bacteria's DNA.
If you're having anal or oral sex, you may also want to ask your doctor to swab for infections in those areas, too. "Unfortunately, many doctors and clinics don't routinely test for oral and rectal infection, especially in women, but you need to test all three areas because if you test for and treat only a genital infection but you have an infection in another part of your body, you'll just pass the infection back to your partner, who will pass it back to you genitally," says Rymland.
You can even test for chlamydia yourself with at-home STI testing kits, which follow a similar process to visiting your doctor IRL. For example, the Nurx STI Home Test Kit includes separate vaginal, throat, and anal swabs to check for infection in any of these locations; you simply swab yourself, and then mail off your sample and wait for the results.
Knowing how serious chlamydia can become if it goes undetected, you should aim to get tested once a year, anytime you notice odd symptoms, or anytime have a new partner — whichever comes first, says Dr. White. This is extra important for women under 25, who are at the highest risk of coming down with chlamydia, adds Dr. Dombrowski. (FYI: Here’s How Often Should You Really Get Tested for STDs)
Chlamydia Treatment
If you test positively for chlamydia, don't overly sweat it; as mentioned, chlamydia can be cured.
Typically, to treat chlamydia, your doctor will prescribe you antibiotics: often a one-time dose of azithromycin or doxycycline, which is taken for seven days, says Dr. White.
In either case, you should abstain from sex for at least a week after you start treatment, according to the CDC. And in that time, you should also notify any past partners that they may have been exposed, recommends Dr. White. While that’s rarely a comfortable conversation to have, it’s much more common than you might think. (There are even organizations, like tellyourpartner.org, which will anonymously notify partners that they’ve been exposed and should get tested.)
On that note, your current sexual partner should also be tested for chlamydia and start antibiotics if needed, according to the CDC. “Patients should talk to their doctor about something called expedited partner treatment,” says Dr. White. While laws differ from state to state, doctors can often write prescriptions for their patient’s partners. This allows them to get chlamydia treatment without going to a doctor or waiting for test results, since the standard course of action is to treat anyone who has been exposed to chlamydia regardless of whether they test positive, says Dr. Dombrowski. If you don’t tell your partner and they don’t get treated (and they are infected with chlamydia), you could become reinfected with the bacteria.
In fact, reinfection is so common that your doctor will likely also recommend retesting after the original antibiotic treatment (to make sure your infection is completely gone), and again after three months, according to the CDC.
Also worth noting: There are no "natural" chlamydia treatments, says Dr. Greenleaf. As with any infection, there are a few things you can do to help your body heal, including rest, hydration, and avoiding stress and inflammatory foods (such as sugar, dairy, gluten, and processed foods), she says. You can also take an over-the-counter pain relief medication (such as ibuprofen or acetaminophen) to treat discomfort.
A chlamydia diagnosis can no doubt be upsetting, but at the end of the day, the presence of microscopic bacteria in your body says nothing about your character or worth as a person. (More here: Your Guide to Dealing with a Positive STI Diagnosis)
How to Protect Against Chlamydia
Here’s the thing: The only completely surefire way to completely avoid contracting an STI is to abstain from sex. However, there are safer-sex practices you can keep in mind to reduce your risk.
Like with other STIs, good practices for preventing chlamydia include using barrier protection like condoms or dental dams, according to the Cleveland Clinic. It’s also a good idea to skip douching, which wipes out the vagina’s good bacteria, making infection more likely, according to the Mayo Clinic.
And, of course, you should know your STI status by getting tested regularly as well as talking to any sexual partners about their STI status as well. It might feel awkward, but remember: STIs are nothing to feel ashamed about. "It's just something that happens, unfortunately, to people who have sex," says Dr. Sung.
