The EPT

What is Chlamydia?

Chlamydia is a hidden bacterial infection which affects the neck of the womb (cervix), womb lining, fallopian tubes and pelvis in women. It is sexually transmitted, affecting the urethra in men and women, and occasionally it causes eye infections (conjunctivitis). It can persist for many years and if left untreated, it can lead to pelvic infection and infertility. It is thought to be responsible for about half of all ectopic pregnancies, particularly in women under 25 years.

Who is at risk?

Anyone who has been sexually active is at risk of getting chlamydia. It is most common at the ages when people are most likely to change partners, with about 1 in 10 twenty year-olds infected at any time. By the age of 40, at least one-third to half of all women – and men – will have had it at some time. The number of new cases has doubled in the past 5 years – probably because more people are being tested, with more accurate tests.

Why is chlamydia so widespread?

Most people – around 8 out of 10 – are unaware that they have the infection. There are rarely any obvious symptoms, so it can remain undetected for many years. Put simply: if you have, or have had, chlamydia, you probably wouldn’t know it, and nor would your partner, so most people who have chlamydia get it from someone else who didn’t know they had it! Thus chlamydia is widespread precisely because it can be silent.

How does chlamydia cause an ectopic pregnancy?

Anything which damages the fallopian tubes – such as endometriosis or previous pelvic surgery – can cause ectopic pregnancy. Chlamydia causes inflammation within the tubes, damaging the tiny hairs which waft the eggs down the tube. The egg gets stuck and this is how an ectopic pregnancy occurs.

How will I know if Chlamydia caused my ectopic pregnancy?

It is normal to look for a reason why you experienced an ectopic pregnancy, but the fact is, for more than half of the UK’s ectopic pregnancies, there is no link, risk or factor known to cause the condition associated with the ectopic pregnancy.

If you have had Chlamydia and it was treated in an acute phase that is a good thing, but the bacteria may already have caused some scarring to the tube and this might possibly be a cause of your ectopic pregnancy. This does not automatically mean your remaining or other tube is affected. Chlamydia does not necessarily cause damage equally to both tubes.

For any woman who has had Chlamydia, it may have contributed to tubal ectopic pregnancy but it may be impossible to tell you if Chlamydia was linke, because the only way we would know would be to remove the tube and examine it to see if there was evidence of scarring associated with Chlamydia.  It is important to remember that even after an ectopic pregnancy there is a chance that your remaining tube is  unaffected, even if the tube you lost was damaged by the disease.

If I have chlamydia does it mean I will become infertile or will have an ectopic pregnancy?

Most women who get chlamydia do not become infertile or suffer an ectopic pregnancy. The reasons for this are unclear, but women’s bodies react differently, similar to an allergy. Risk of ectopic pregnancy is increased by repeated infection with chlamydia or lack of treatment.

How might I know I had chlamydia?

Although chlamydia is usually silent, you might have noticed:

• Spot bleeding between periods or after sex
• Discomfort or soreness when you urinate or
• A need to urinate more frequently
• Increased or changed vaginal discharge (different colour, smell or amount)
• Lower abdominal pain or pain during sex
• Pain in the upper part of the tummy, on the right side.

Even though most people don’t get any signs of the infection you may notice some changes 1-3 weeks after having sex.

Men might notice:

• discharge from the penis;
• pain or burning when peeing.

Women may notice:

• a change in the normal discharge from the vagina;
• more frequent or painful peeing;
• pain during sex;
• bleeding between periods or irregular periods.

The difficulty in trying work it out yourself, is that these symptoms can also be caused by lots of other things as well. Guesswork just isn’t going to give you an answer so you need to ask yourself, am I actually at risk of having caught Chlamydia or any other sexually transmitted infection in the last year or so? If the answer is yes, then get checked out.

How is chlamydia treated?

You and your partner must take a simple course of antibiotics simultaneously. This ensures that you are not reinfected. You will also be asked for your sexual history so that your contacts can be traced and treated to prevent the spread of this infection. Treatment is free at sexual health/genitourinary clinics and there are no prescription charges. These services are confidential and you don’t need to be referred by your GP. Simply phone for an appointment or to find out about opening times.

What about my partner?

The most difficult thing is often telling your partner. At the time of the ectopic pregnancy, it is often difficult to identify chlamydia by testing, and chlamydia may not have caused YOUR ectopic. Among male partners of women proven to have chlamydia, up to 90% are infected with no symptoms. Remember that chlamydia can persist for a long time, and either of you might easily have acquired the infection before you met. It is impossible to tell from tests how long the infection may have been there. Also, the damage may have been done years previously, in which case the infection won’t be found now.

How can I protect myself from chlamydia?

The AIDS campaign in the 1980s promoted the use of condoms, but made no mention of getting check-ups. There was NO significant reduction in cases of chlamydia or pelvic infection and there was a gradual rise in ectopic pregnancy. This is because condoms only protect if you use them every time, in short-term or one-off situations. So if you have a new partner, ensure that you are both checked out for chlamydia before you stop using condoms.

If you have experienced an ectopic pregnancy, you should be checked for chlamydia. Although treatment will not correct the damage already done, it may prevent further damage.

Should I have a Chlamydia test?

In women, if not treated, chlamydia may lead to pelvic inflammatory disease, fertility problems, ectopic pregnancy (where the baby grows outside the womb) and chronic pelvic pain. The more people who have sex with an infected partner, the more likely you are to get it but you only need to have unprotected sex once to be at risk.

The more times that you get chlamydia the higher your chances of not being able to have a baby (even if treated). If left untreated, there is evidence to suggest that chlamydia may affect men’s fertility as well.

All under 25s who are sexually active are encouraged to take a test for chlamydia each year and every time they change their sexual partner. This is the only way to make sure you are clear of the infection and stay clear of the infection.  There are special NHS testing programmes in most regions for anyone under 25, to help make it easier to get tested. The tests are free and so is any extra treatment that might be needed. Read more about how to get a test for all age groups

Should I test for Chlamydia, after I have had an ectopic pregnancy?

If there is a chance you have been infected in the last three to six months then it is always worth taking a test. Some hospitals routinely take swabs but many do not.

Chlamydia is a bacteria and our bodies are designed to fight bacteria very effectively. If an ectopic pregnancy was caused by Chlamydia, the infection that did the damage may be long gone and so will not be detectable on a Chlamydia test which is done by testing urine or taking swabs. There will be evidence of antibodies in the blood in anyone whose had Chlamydia but because testing blood will not alter the doctors assessment or treatment or give them any more information than they already have, testing for antibodies isn’t routinely available. What’s more, even if you did have the blood test and it showed positive antibodies, it doesn’t mean that it was the cause of your ectopic pregnancy. However it is known that women with a history of Chlamydia also have an increased risk of ectopic pregnancy.

How can I get a test?

More information on how to get a test can be found here

What about other sexually transmitted infections?

You can read about other STIs.