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chlamydia infection in females

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Female reproductive organs

Chlamydia is a sexually transmitted disease, or STD, caused by the organism Chlamydia trachomatis. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. In women, the infection usually occurs in the urinary tract, pelvis, or cervix. The cervix is the opening between the vagina and the uterus.

What is going on in the body?
The organism Chlamydia trachomatis causes chlamydia infection. It infects the cells and causes a number of changes. The organism is usually passed from one partner to another during sexual intercourse. An infection can also be passed from an infected mother to her baby during birth. This can cause eye infections or pneumonia in the infant.

What are the signs and symptoms of the infection?
Most chlamydia infections do not cause any symptoms. For this reason, a sexual partner may be exposed without either partner knowing it. They may pass the organism to other unsuspecting partners. In Australia the infection rate for Chlamydia in 1998 was 87.7 cases per 100000. This was an increase from 74.5 per 100000 in 1997. It was also the third highest rate reported for any notifiable disease.

Symptoms of a chlamydia infection of the cervix in a female may include the following:
  • vaginal discharge
  • mild pain and discomfort when urinating
  • abdominal distress, if the infection has spread to the uterus, tubes, or ovaries
  • pain in the upper right of the abdomen, if the liver is involved
Chlamydia infections of the throat usually cause a sore throat.

Chlamydia infections of the rectum can cause the following:
  • rectal pain
  • discharge from the rectum, which may be bloody
  • frequent, painful urges to have a bowel movement
What are the causes and risks of the infection?
The organism that causes a chlamydia infection is usually passed from one partner to another during sexual intercourse. Any other intimate contact of the genitals, mouth, rectal area, or the sharing of sexual toys can transmit the organism from one individual to another.

Factors that make some women more likely to have a chlamydia infection are as follows:
  • being sexually active and younger than 16 years old
  • having a low socio-economic status
  • not using barrier methods of contraception, such as condoms
  • having multiple sexual partners
  • using oral contraceptives
  • having sex with a partner who has previously had a sexually transmitted disease
  • having sex with a male who has a chlamydia infection of the urinary tract
What can be done to prevent the infection?
Several safer sex practices can help prevent the spread of chlamydia infection. Male condoms and female condoms provide some protection. Single partner relationships are safer than sexual interaction with multiple partners.

Any new partners should be asked about their sexual history and should be tested for sexually transmitted disease. Sexual contact should be postponed until the tests show no infection in the partner.

Finally, a screening for chlamydia can be done in combination with a routine annual Pap smear and pelvic examination.

How is the infection diagnosed?
The doctor may suspect a chlamydia infection after taking a medical history and performing an examination. The doctor may take a sample of material from the infected area to be checked in the laboratory for the organisms that cause the infection. For a cervical infection, this would involve a pelvic examination and a culture of material from the surface of the cervix. A throat culture may be ordered if a chlamydia infection of the throat is suspected.

What are the long-term effects of the infection?
Chlamydia infections in females are strongly associated with the development of cervical dysplasia, or abnormal cells in the cervix, and cancer of the cervix.

It is important to treat chlamydia infections to prevent scarring of the fallopian tubes, which connect the ovaries to the uterus. Severe or untreated chlamydia infections can cause serious complications such as the following:
  • pelvic inflammatory disease, or PID, which involves a widespread infection of pelvic organs
  • chronic pelvic pain
  • pelvic adhesions, or bands of tissue that cause scarring
  • infertility, or the inability to conceive a child
  • ectopic pregnancy, in which the fertilised egg implants outside of the uterus
  • premature labour and premature delivery, if a woman is infected during pregnancy
  • postpartum endometritis, an infection of the uterine lining that occurs after a woman has given birth
  • proctitis, or rectal infection
What are the risks to others?
Chlamydia infections are highly contagious and can be passed through sexual intercourse and other intimate contact. A woman who is pregnant can pass the chlamydia infection to her baby during delivery. The baby may then develop an eye infection or pneumonia.

What are the treatments for the infection?
Taking antibiotics usually cures the infection. Normal healing may still leave some scar tissue. Sexual partners should also be treated. Sometimes a combination of antibiotics is used for 7 to 10 days. Antibiotics used to treat chlamydia infections include azithromycin, doxycycline, and erythromycin.

For severe infections that spread to the abdomen, antibiotics are injected into a vein. This procedure is done in the hospital. It is important to note that having the infection does not make one immune to it. Anyone can be infected repeatedly.

What are the side effects of the treatments?
Antibiotics may cause stomach upset, rash, or allergic reactions.

What happens after treatment for the infection?
Antibiotic treatment usually works, but there may still be scarring of the woman's reproductive organs. Someone who does not finish taking the entire course of antibiotics can be reinfected. Reinfection may also occur unless all sexual partners are treated. In some cases, chlamydia infections do not clear up. This can be due to organisms that are resistant to antibiotics.

How is the infection monitored?
After a course of antibiotics has been taken successfully, the doctor may repeat the culture of material from the infected area. If the test is positive, it usually means reinfection has occurred. This is particularly likely if a sexual partner has not been treated or did not complete treatment.

Being screened for chlamydia every year, or any time there is a new sexual partner, is a good practice. Any new or worsening symptoms should be reported to the doctor.

Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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