Chlamydia Infection In Females

Definition of Chlamydia Infection In Females

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

What is going on in the body?

The organism Chlamydia trachomatis causes chlamydial infection. The organism is usually passed from one partner to another during intimate sexual contact. 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 chlamydial 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.

Symptoms of a chlamydial infection of the cervix in a female may include the following:

• cervical 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

Chlamydial infections of the throat usually cause a sore throat. Chlamydial 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 chlamydial infection is usually passed from one partner to another during intimate sexual contact. 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 chlamydial infection are as follows:

• being sexually active and younger than 20 years old
• having a low socioeconomic status
• not using barrier methods of contraception, such as condoms
• having more than one sexual partner
• using the birth control pill, which is thought to be related to more frequent sexual activity
• having sex with a partner who previously has had a sexually transmitted infection
• having sex with a male who has a chlamydial infection of the urinary tract

What can be done to prevent the infection?

Several safer sex practices can help prevent the spread of chlamydial infection.

Male condoms and female condoms provide some reduction of risk by decreasing the chance of infection by 50% with each act of intercourse. 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 infection or disease.

It is recommended that all single, sexually active women who are less than 25 years of age should be screened annually for Chlamydial infection. 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 test and pelvic exam.

How is the infection diagnosed?

The provider may suspect a chlamydial infection after taking a medical history and performing an examination. The provider 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 inside of the cervix. A throat culture may be ordered if a chlamydial infection of the throat is suspected.

What are the long-term effects of the infection?

It is important to treat chlamydial infections with symptoms of lower abdominal pain in order to prevent scarring of the fallopian tubes, which connect the ovaries to the uterus.

Severe or untreated chlamydial 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 fertilized egg implants outside of the uterus
• premature labor and premature delivery, if a woman is infected during pregnancy
• postpartum endometritis, an infection of the uterine lining that occurs shortly 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 if PID is suspected.

Antibiotics used to treat chlamydial infections include:

• azithromycin (i.e., Zithromax, Zmax)
• doxycycline (i.e., Adoxa, Doryx, Oracea, Periostat, Vibramycin),
• ofloxacin (i.e., Floxin),
• levofloxacin (i.e., Levaquin),
• extended spectrum penicillins, and
• erythromycin base or erythromycin ethylsuccinate (i.e., EES).

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, chlamydial infections do not clear up. This can be due to organisms that are resistant to the antibiotics used, because the antibiotics were not used for a long enough period of time the wrong antibiotics were prescribed. or the patient resumed sexual activity with an infected partner.

How is the infection monitored?

After a course of antibiotics has been taken successfully, the healthcare provider 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 healthcare provider.