Chlamydia & Gonorrhea
Chlamydia and Gonorrhea are two of the most common STIs. Symptoms can include a thick urethral discharge, minor discomfort with urination, pink eye, anal abnormalities, or no symptoms. Samples for testing are obtained by collecting urine from males (after not voiding for at least one hour) or a vaginal swab in females. These samples can be self-obtained. If there is a risk of infection in the throat or anus, swabs of these areas are generally obtained by a medical provider.
Chlamydia and gonorrhea can be prevented by use of condoms or another barrier method. However, once an individual contracts one of these infections, they are treated and cured with antibiotics. Untreated infections can cause pelvic inflammatory disease, sterility, infections in joint fluid, abscesses, and blindness.
Men and women should be tested (screened) for chlamydia and gonorrhea even if they do not have symptoms or know of a sex partner who has had these infections. The CDC recommends yearly chlamydia and gonorrhea screening of all sexually active individuals especially those younger than 25 years old, with new or multiple partners, or who have a sex partner who has a sexually transmitted infection.
Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STI should see a health care provider for evaluation. Sexually active men who have sex with men (MSM) who had insertive intercourse should be screened for urethral chlamydial infection and MSM who had receptive anal intercourse should be screened for rectal infection at least annually. More frequent chlamydia screening at 3-month intervals is indicated for MSM, including those with HIV infection, if risk behaviors persist or if they or their sexual partners have multiple partners.
Chlamydia is the most frequently reported bacterial sexually transmitted infection in the United States. A large number of cases are not reported because most people with chlamydia are asymptomatic and do not seek testing. Chlamydia is most common among young people. Almost two-thirds of new chlamydia infections occur among youth aged 15-24 years. It is estimated that 1 in 20 sexually active young women aged 14-24 years has chlamydia.
Gonorrhea is a very common infectious disease. CDC estimates that approximately 820,000 new gonococcal infections occur in the United States each year, and more than half of these infections are detected and reported to CDC. CDC estimates that 570,000 of them were among young people 15-24 years of age.
Chlamydia and gonorrhea are transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for chlamydia or gonorrhea to be transmitted or acquired. Men who have sex with men (MSM) are also at risk for chlamydial and gonorrheal infection since both can be transmitted by oral or anal sex.
People who have had chlamydia or gonorrhea and have been treated may get infected again if they have sexual contact with a person infected with chlamydia. The infection may also be transmitted by individuals infected with chlamydia or gonorrhea if they do not wait the appropriate length of time to have unprotected intercourse after completion of antibiotics.
Chlamydia is known as a ‘silent’ infection because most infected people are asymptomatic and lack abnormal physical examination findings. When symptoms do occur in men, they may include burning with urination, mucus-like and/or watery discharge from the penis, and/or one-sided testicular pain, tenderness, and swelling. In women, symptoms may include abnormal/increased vaginal discharge, abnormal vaginal bleeding, burning, urgency, or frequency with urination, and/or abdominal and/or pelvic pain. Chlamydia infections can also cause pink eye symptoms and rectal pain, discharge, and/or bleeding in both men and women.
Many men and women with gonorrhea are also asymptomatic. When present, signs and symptoms of urethral infection in men include burning with urination or a white, yellow, or green penile discharge that usually appears one to fourteen days after infection. Symptoms in women are similar to those seen in chlamydia. Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Rectal infection also may be asymptomatic. Pharyngeal infection may cause a sore throat, but usually is asymptomatic.
Chlamydia and gonorrhea specimens may be obtained by urine samples and swabs from the vagina, urethra, rectum, throat, or endocervix.
WHAT TO DO IF POSITIVE: Chlamydia and gonorrhea can be easily cured with antibiotics (azithromycin and doxycycline). The CDC now recommends using two drugs (dual therapy) for the treatment of gonorrhea. Persons (and their partners) being treated for chlamydia and gonorrhea should abstain from all forms of sexual activity (oral, vaginal, and rectal) for 7 days after completion of antibiotics to prevent spreading the infection to partners. It is important to take all of the medication prescribed to cure these infections. Medication for chlamydia and gonorrhea should not be shared with anyone. Although medication will cure the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult. If a person’s symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated.
Repeat infection with chlamydia is common. Women whose sex partners have not been appropriately treated are at high risk for reinfection. Having multiple chlamydial and/or gonorrheal infections (especially those left untreated) increases a woman’s risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia and/or gonorrhea should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated.
If you have been diagnosed and treated for chlamydia and/or gonorrhea, you should tell all recent anal, vaginal, or oral sex partners (all sex partners within 60 days before the onset of symptoms or diagnosis) so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from these infections and will also reduce your risk of becoming reinfected. You and your sex partners must avoid having sex until you have all completed your treatment for these infections and until any symptoms have resolved. For tips on talking to partners about sex and STI testing, visit www.gytnow.org/talking-to-your-partner/External
If you have more questions about chlamydia, refer to the CDC’s website: https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm
If you have more questions about gonorrhea, refer to the CDC’s website: https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm