Chlamydia and Gonorrhea

Chlamydia

Chlamydia (chlamydia trachomatis) is the most prevalent sexually transmitted bacterial infection. This bacterial infection affects 3-4 million people each year. It is the most common cause of pelvic inflammatory disease (PID), ectopic pregnancy and infertility in women. Chlamydia is a frequent cause of testicular and prostate infections and is the most common cause of sterility in men. Chlamydia can cause discharge from the penis.

Gonorrhea

Gonorrhea (neisseria gonorrhoeae) is a bacterial infection that often co-exists with chlamydia. Approximately 700,000 new gonorrhea infections occur every year. These bacteria can also cause PID, ectopic pregnancy and infertility in women and testicular and prostate infections in men. This bacterium may also grow in the mouth, throat, eyes and anus.

Transmission/Symptoms

Chlamydia and gonorrhea are transmitted through vaginal, anal or oral sexual contact. Both infections cause symptoms for some people while other people have no recognizable symptoms at all. Both infections can be transmitted from infected mother to child during vaginal delivery. Both bacterias can be transmitted even if ejaculation does not occur. For women, symptoms include a change in the color or texture of vaginal discharge, irregular bleeding or spotting, vaginal burning, or pain and burning with urination. Pelvic pain may indicate that the bacteria have progressed into the uterus, fallopian tubes and ovaries. Because it is more common that women may not have recognizable symptoms, the Centers for Disease Control and Prevention recommend that all sexually active adolescent and young adult women be tested during their annual exam. Any woman having new or multiple partners should request testing.

Men may have mild burning with urination and may notice a yellow to gray penile discharge with or without testicular pain. Symptoms may resolve without treatment even though the infection is still present. Examination is recommended for symptoms of discharge or pain and burning with urination even if the symptoms have spontaneously resolved. Gonorrhea symptoms may develop within 2-10 days, but symptoms may take up to 30 days before they appear, while chlamydia symptoms may occur 7-21 days after exposure.

Symptoms of gonococcal infections of the throat include redness and swelling of the tonsils, sometimes accompanied by exudate (white spots) on the tonsils. Ano-rectal symptoms include rectal pain and bleeding.

Diagnosis

Testing for chlamydia and gonorrhea involves taking a sample of cells from the urethra or cervix using a small cotton swab. A urine specimen obtained after not urinating for at least two hours is sometimes used as an alternative method of testing. McKinley does not have the capability to test for oral chlamydia. If you have had oral contact with a partner known to have chlamydia, treatment will be provided.

Routine screening in the absence of symptoms should be performed approximately two weeks after a suspected exposure to ensure accuracy of the testing. Since chlamydia and/or gonorrhea may occur simultaneously with other infections, such as hepatitis B, syphilis, and HIV, additional testing may be recommended. Repeated testing may be done if desired, 3-4 months after evaluation and treatment.

Treatment

Chlamydia and Gonorrhea are treated per the Centers for Disease Control and Prevention guidelines.

You and your sexual partner(s) must be treated and must complete the prescribed medication. Any sexual partners in the preceding 60 days should be evaluated, tested, and treated. The most recent sexual partner should be evaluated and treated even if the last sexual contact was more than 60 days before the diagnosis. You must abstain from all sexual contact for seven days after completing the treatment. You must also abstain from all sexual contact until your current sex partner(s) are treated or you will be re-exposed and will need to be retreated. If symptoms do not clear or re-occur after treatment is completed it is important to return to your health care provider for further evaluation.

Prevention

The most effective way to prevent acquiring Chlamydia or Gonorrhea is abstain from sexual intercourse or to have a long-term mutually monogamous relationship. Consistent condom use can reduce, but not totally prevent the transmission of sexually transmitted infections. It is important to talk with all new sexual partners about their sexual history. Although gonorrhea and chlamydia testing can be performed, there are other sexually transmitted infections that may be transmitted even though no symptoms are present.

Instructions for Partners

If your partner has been found to have chlamydia and/or gonorrhea, recognize that the infection can be present for years without symptoms. It is important that you seek medical attention to be evaluated and treated. It is important to finish all of the medication even if your chlamydia test is negative. Refrain from all sexual contact until you both have been examined and have completed treatment. The use of condoms is recommended to prevent re-infection.

If you are a female

For an accurate examination, please do not use any vaginal medications, tampons or have sexual intercourse for at least 24 hours prior to your appointment.

If you are a male

For an accurate exam, please report to the appointment without urinating for at least two hours.

If you are not a registered University of Illinois student

You will need to seek medical attention from your own or local provider. A public health facility offers testing and treatment free of charge. For the Champaign-Urbana, Illinois Public Health District, call 352-5359 or visit their Web site at www.c-uphd.org.

References

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2006.
MMWR 2007; 56: 332-6.