Symptoms of Chlamydia infection in women: Overview
A chlamydia infection may affect various organs and, among the others, the reproductive system. Therefore, this infection is classified as one of the sexually transmitted diseases. Of note, genital infections caused by Chlamydia trachomatis are the most common bacterial STD. Eventually, this infection may result in infertility.
Chlamydiae are the gram-negative organisms which infect the columnar and transitional epithelial cells and thrive within them, therefore these microorganisms are known as obligatory intracellular bacteria. Bacteria are transmitted during sexual contact and may be acquired by the baby during childbirth. The incubation period for Chlamydia infection usually lasts from 1 to 3 weeks (on average 6-14 days). Chlamydia trachomatis serovars D-K are typically detected in individuals with STD and affects the urethra, cervix, uterus, and salpinges in women.
There are multiple factors associated with increased risk of Chlamydia infection:
- young age (younger than 25 years);
- having a sexually transmitted infection and not getting a proper treatment;
- bacterial vaginosis;
- having multiple new sex partners and symptomatic sex partners;
- having sex without a condom;
- a history of the pelvic inflammatory disease;
Symptoms of chlamydia infection are non-specific, furthermore, in up to 75% of cases, the infection may remain asymptomatic, making it possible for the infection to be transmitted.
However, the presenting features of the Chlamydia infection in women may include the following:
- Dysuria (pain while voiding) and frequency for more than 7-10 days;
- Pyuria (the presence of pus in urine);
- Dyspareunia (painful sexual intercourse);
- Postcoital bleeding;
- Intermenstrual bleeding (bleeding in-between the periods);
- Lower abdominal pain;
- Purulent cervical discharge;
The high prevalence of asymptomatic cases accounts for the frequent development of infection complications because of inappropriate or completely absent treatment.
- Perihepatitis (the Fitz-Hugh-Curtis syndrome) may occur in young individuals who have a Chlamydia infection due to the spread of bacteria via lymphatic vessels and the peritoneal cavity. The disorder may be suspected when a person develops pain in the right upper quadrant of the abdomen, fever, and nausea;
- Long-lasting, even asymptomatic disease causes tubal scarring and obstructs the Fallopian tubes leads to ectopic pregnancy and female infertility;
- Cervical and urethral swabs should be obtained to detect the bacteria, rapid tests which detect the Chlamydia antigens are also available;
- Nucleic acid amplification testing (NAAT) of the urine is performed to detect the Chlamydia;
- Detection of immunoglobulins IgG and IgM in the blood reveals chronic or acute infection;
- A pregnancy test is obligatory for women with suspected Chlamydia infection to choose the safest treatment option if a woman is pregnant;
- CT and ultrasonography of the abdomen and pelvis may be required when Chlamydia infection complications are suspected;
Sometimes infection resolves spontaneously, although it may also persist. Antibiotics such as azithromycin and doxycycline are usually prescribed to treat Chlamydia infection. It is worth mentioning that azithromycin given in a single dose is considered as effective as a 7-day regimen of other antibiotics.
The sexual partner has to be treated with the same antibiotic.
- Azithromycin 1 g orally as a single dose or
- Doxycycline 100 mg twice a day for 7 days or
- Tetracycline 500 mg four times daily for 7 days or
- Erythromycin 500 mg four times a day for 7 days;