Chlamydia treatment

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

Chlamydia is the UK's most common STD

Chlamydia is the most common sexually transmitted disease in the UK, accounting for 50% of sexually transmitted infections. The highest prevalence is in those aged 15-24 years.

Chlamydia in men is most commonly an infection of the urethra (where urine comes out). In women it is most commonly an infection of the neck of the womb (inside the vagina). Infection can also occur in the anus, mouth, and even eyes.

People who have a Chlamydia infection may not know they have it, particularly women, in whom symptoms are often absent. Most people with an infection are unaware of it.

Chlamydia can cause long term complications. In women this can include pelvic inflammatory disease (PID), tubal infertility, and ectopic pregnancy. Men with active infection may have reduced sperm quality, although this recovers when infection is treated.

Chlamydia is spread mainly by penetrative sexual intercourse, although the exact details are not fully understood. It is considered highly infectious. It can also be spread through oral sex. The infection can sometimes be detected in the conjunctiva of the eyes and in the lining of the mouth, even when there is no genital infection.

The use of condoms, femidoms, and dental dams reduce the chance of infection, but does not eliminate it completely. In many areas the NHS provides free condoms especially if you are under 25 years (see sexual health clinic links below).

Untreated chlamydia sometimes clears on its own, with 50% resolving after 12 months. This is not a reason to delay or avoid treatment due to the possible long-term complications it can cause.

Confidential chlamydia testing

Sexually active people should test for chlamydia every year and when they have a new partner.

Free chlamydia testing through the national chlamydia screening programme offers tests to women aged under 25, and in some areas to men under 25, and other age groups as well. Contact your local NHS Sexual Health Clinic:

• England
• Wales
• Scotland
• Northern Ireland

Chlamydia tests, other STI tests, treatment, and advice are available through sexual health clinics, some walk-in centres, and some GPs.

Postal test kits

In many areas free home chlamydia tests are available by post and can be completed in the security of your own home. Chlamydia tests are often combined with tests for gonorrhoea and sometimes tests for other STIs as well.

A chlamydia test kit can also be bought online for delivery by post.

Testing is carried out on a urine sample in men, whilst in women testing is carried out on a self-taken vaginal swab.

• Post the sample to the lab in the envelope provided.
• A few days later the result is posted, emailed, or texted back to you.

Testing for other sexually transmitted diseases

Chlamydia infection is often associated with other sexually transmitted diseases. If a chlamydia test is positive, a full range of tests for other sexually transmitted diseases should also be undertaken, if not already done. Local sexual health clinics can advise about tests and treatment for STIs. Some tests take longer to turn positive after you become infected and your local sexual health clinic can also advise about this.

Regular HIV testing should also be carried out for those at increased risk: men who have sex with men; people from sub-Saharan Africa; people who share needles, syringes, or other injecting equipment; and sex workers. See also HIV testing guidelines 2020.

Partner notification

It is important if you have tested positive for chlamydia to inform your previous sexual partners from the last 6 months. As chlamydia is often asymptomatic, they themselves may also have it and not be aware. They need testing and possible treatment. If you need help and advice on how to do this, sexual health clinics can arrange anonymous partner notification for you.

Antibiotic chlamydia treatment

Chlamydia is usually treated with the antibiotic doxycycline 100mg taken twice daily for 7 days.

There is an alternative treatment for patients who are intolerant/allergic to doxycycline: azithromycin 1g as a single dose followed by 500mg daily for 2 days.

Doxycycline treatment is about 98% effective and azithromycin treatment 97% effective in eliminating infection. The course of treatment must be completed.

The 1g one-off dose of azithromycin suggested in the patient information leaflet is no longer a recommended treatment regime due to increasing resistance in other sexually transmitted infections and it is not as effective in treating complicated infections.

Additional treatment advice

• Avoid sexual contact for 7 days from starting treatment whilst taking doxycycline or for 7 days after completing treatment with azithromycin.
• Sexual partners should be informed of your need for chlamydia treatment and, if possible, be treated at the same time
• Tests take up to 6 weeks to go negative after chlamydia has been successfully treated, but a test of cure is not usually recommended in straightforward infection.
• It is recommended to have another test 3 months after treatment if you are under 25, as it is common to become infected again.
• Chlamydia treatment should not be repeated within 3 months without consultation with your doctor or a specialist clinic. Tests and treatment for other infections and additional advice about avoiding infection may be needed.

Side effects of doxycycline

Serious side effects of doxycycline are unusual. The most frequent being upset stomach, nausea, and diarrhoea. Doxycycline can cause light sensitivity. Strong sun and sunbeds should be avoided whilst doxycycline is being taken.

For a full list of side effects please read the doxycycline 100mg patient information leaflet.

Side effects of azithromycin

The most common side effects of azithromycin are nausea, vomiting, diarrhoea, abdominal pain, and headache.

For a full list of side effects please read the azithromycin 500mg patient information leaflet.

Cautions - when NOT to self-treat

Men who have a thick or bloody discharge from the penis with soreness or inflammation, women with heavy offensive vaginal discharge or irregular bleeding and low abdominal pain and men or women, who have anal/rectal discharge (from the back passage) which may be bloody, should not self treat. They should see their regular doctor/GP/sexual health clinic for full STI testing as different treatment regimes may be required for other sexually transmitted infections.

Discharge is mucus like fluid coming from the end of the penis, vagina, or anus.

Doxycycline is not suitable for women who are pregnant or breastfeeding, nor people with liver disease, systemic lupus erythematosus, myasthenia gravis, or porphyria.

Alternative treatment

Alternative antibiotics (not available from Dr Fox), include erythromycin and ofloxacin. These antibiotics are an option in people who cannot take doxycycline or azithromycin. Contact a local sexual health clinic or your GP if you think you need a different treatment.

Chlamydia symptoms

Half of men and the majority of women have no symptoms.

Chlamydia does not usually produce open sores or blisters. If these are present a GP, GUM clinic, or sexual health clinic should be consulted.

Women

The majority of infections in women are asymptomatic (without any symptoms). When there are symptoms these could include:

• Increased vaginal discharge
• Unusual vaginal bleeding
• Bleeding between periods
• Heavier periods
• Pain (and/or bleeding) during sex
• Bleeding after sex

Men

Symptoms in men may be so mild as to go unnoticed. Where symptoms are present these could include:

• A white/cloudy or watery discharge from the penis
• Burning and itching in the genital area
• Pain when passing urine
• Painful swelling of the testicles (epididymitis)
• Anal pain and inflammation (proctitis)

Many of these symptoms in men and women can also be caused by other infections and conditions. If you have any of these symptoms get a full check up with a GP, sexual health or GUM clinic.

Both men and women: non-genital symptoms

• If the infection is in the rectum/anus there are rarely any symptoms although there can sometimes be discomfort and discharges.
• Infection in the eyes can cause mild irritation. It may affect one eye or both.
• Infection in the throat isn't common and doesn't usually produce symptoms.

If you think you have non genital chlamydia infection, speak to a GP, sexual health or GUM clinic.

Complications and long term effects of infection

Possible complications of infection in women include pelvic inflammatory disease (PID), salpingitis, endometritis, tubal infertility, ectopic pregnancy, sexually acquired reactive arthritis (SARA) (<1%), and perihepatitis.

Complications in men include SARA and epididymo-orchitis.

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Antibiotic guardianship

To combat antibiotic resistance please:

• Only use antibiotics when needed
• Never share antibiotics
• Always complete course as instructed
• Take unused medicine to local pharmacy for disposal

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Buy treatment

Dr Fox supplies chlamydia medication on prescription - you are required to answer a short medical questionnaire before your order can be completed.

1. Medical questions
2. Choose treatment
3. Complete order

Answer medical questions to order(chlamydia)

Honest & accurate responses are necessary for safe medical assessment