Conditions Chlamydia

Chlamydia trachomatis is a type of bacteria that can cause inflammation. Various forms of Chlamydia trachomatis exist worldwide, which cause different diseases. This article discusses the forms of chlamydia that are most prevalent in Germany. These can cause pus-producing inflammation of the organs involved in sexual intercourse. They can also cause conjunctivitis.

Chlamydia is a sexually transmitted infection (STI), which means that it can be passed from person to person during sex, for example.

Chlamydia is the most common cause of inflammation of the cervix in women. In men, chlamydia usually causes inflammation of the urethral opening (the hole at the tip of the penis).

However many of those infected do not have any symptoms. That means the disease can spread unnoticed.

With inflammation of the sex organs, around 80 percent of women and around 50 percent of men have no symptoms. In the remaining cases, symptoms such as the following may occur:

• itching, pain and a burning sensation when urinating and during sexual intercourse
• a pus-containing discharge from the vagina or penis
• depending on sexual practices, also ulcerous inflammation of the rectum and the throat

If the inflammation spreads, it can extend from the cervix to the womb, fallopian tubes and abdominal cavity. It is possible for a person to experience no symptoms despite the inflammation. Alternatively, it may cause a feeling of being very unwell, with abdominal pain, fever, nausea or vomiting. In rare cases, the inflammation can spread within the abdominal cavity until it reaches the region of the liver. In men, the infection can spread to the prostate gland and epididymis (the tube at the back of each testicle) and be very painful. Infertility may be a late complication in both women and men.

Painful symptoms may occur at the joints and in the tendons a few weeks after the acute stage. These joint problems usually resolve by themselves.

If a person becomes infected with chlamydia in the intestines, this may lead to chronic intestinal inflammation in the long term.

Conjunctivitis due to chlamydia frequently affects first one eye and then both. In most cases, the eyes appear red and a sticky discharge may form.

If a pregnant woman is infected, the baby may become infected during the birth. The newborn baby may then contract purulent conjunctivitis, a middle ear infection and, in rare cases, pneumonia. Occasionally, premature births and other complications in pregnancy can also be due to infection with chlamydia.

You can assess your risk of contracting chlamydia and other sexually transmitted infections (STIs) using an anonymous online test on the website of the WIR – Walk In Ruhr, Center for Sexual Health and Medicine (Zentrum für Sexuelle Gesundheit und Medizin).

Chlamydia infections are caused by a type of bacteria called Chlamydia trachomatis. This type of bacteria only occurs in humans and is passed on through sexual contact. If the person infected is pregnant, chlamydia may also be passed on to the baby at birth.

If conjunctivitis occurs, the bacteria are often transferred through direct contact with the hands (smear infection). 

Chlamydia is one of the most common sexually transmitted diseases. In Germany, chlamydia is particularly common among sexually active adolescents and young adults. Its prevalence can only be estimated because it is not a notifiable disease. However, some scientific studies estimate that around 1 in every 10 sexually active girls are infected with chlamydia.

The likelihood of contracting chlamydia decreases with age and for people in committed partnerships.

Chlamydia may also occur in conjunction with other STIs, such as gonorrhea (“the clap”).

Safer sex (or safe sex) means taking measures to reduce your risk of becoming infected with sexually transmitted diseases. These measures include, for example, using condoms or femidoms. Femidoms work in the same way as condoms but are worn inside the vagina. They provide the same level of protection as condoms against sexually transmitted infections.

Condoms and femidoms reduce the risk of infection with chlamydia and other sexually transmitted infections when used consistently and correctly. However, they do not offer 100 percent protection. Anyone who suspects they may have chlamydia should make an appointment with the doctor and abstain from sexual intercourse in the meantime.

If the person is pregnant, a test for chlamydia is covered by German statutory health insurance providers as part of prenatal care benefits. This screening test should also be performed before a termination.

Chlamydia screening is done by a gynecologist. A urine sample must be provided for testing. If the test is positive, all sexual partners from the last 60 days should also take a test and be treated if necessary.

Men can also have the cost of testing covered by their statutory health insurance provider if they suspect that they have been infected with chlamydia.

In individual cases, doctors may consider prescribing an antibiotic on a preventive basis to prevent infection with chlamydia. This is relevant for people who are at a particularly high risk of infection.

Doctors use various methods to detect chlamydia directly. They generally take swabs from the affected areas or samples of urine or semen. The most reliable way is to use molecular biology-based methods to detect the genetic material of the bacteria, such as polymerase chain reaction, or PCR for short. The samples are sent to a lab for testing and the result is normally available after a few days.

Where to get tested for chlamydia

Doctors specializing in skin diseases, sexually transmitted diseases, gynecology and urology all provide testing for chlamydia and other sexually transmitted infections (STIs). Statutory health insurance providers will cover the costs of these tests for individuals who suspect they are infected.

Public health authorities and test centers operated by the German AIDS Federation (Deutsche Aidshilfe) also offer testing for chlamydia and other STIs. They also provide an anonymous testing option.

It is also possible to test for chlamydia using at-home sample collection kits. With this option, samples or swabs are taken at home and then sent by mail to a lab for analysis. 

For more information about tests for sexually transmitted diseases, see the German AIDS Federation (Deutsche Aidshilfe) website.

Antibiotics can be used to treat chlamydia. However, it is possible to become reinfected within a short period of time or for treatment to be unsuccessful for other reasons. To avoid this, it is particularly important to:

• consistently take the correct dose of prescribed antibiotics for the entire duration of the prescription
• ensure that sexual partners are also treated – otherwise, the risk of reinfection is high
• get tested again several weeks or months after treatment – the same applies to sexual partners
• avoid sex during the treatment period

“Liebesleben” (Love life) is the website of the Federal Institute for Public Health (Bundesinstitut für Öffentliche Gesundheit, BIÖG). It provides information about sexually transmitted infections (STIs) such as chlamydia, as well as about love, sex and protection.

The WIR – Walk in Ruhr, Center for Sexual Health and Medicine (Zentrum für Sexuelle Gesundheit und Medizin) also provides information about chlamydia infections and other STIs.

The German STI Society – Society for the Promotion of Sexual Health (Deutsche STI Gesellschaft – Gesellschaft zur Förderung der Sexuellen Gesundheit, DSTIG) also provides extensive and important information.

Who to talk to about a chlamydia infection

Our article about protection against sexually transmitted diseases also provides information about sources of advice and support in relation to chlamydia and other STIs.