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Everything You Need to Know About Chlamydia

Two-thirds of all reported chlamydia cases were people between the ages of 15 and 24.
illustration chlamydia
Theresa Chromati

Chlamydia. Just the name sounds ominous, doesn't it? Like some alien creature from a 1950s cult film. Your main reference point for chlamydia might even be that hilarious (but disturbing) sex ed lesson from the Tina Fey comedy Mean Girls. "You're going to want to take off your clothes, and touch each other," the teacher warned. "But if you do touch each other, you will get chlamydia… and die."

It's not quite that bad, but cases of chlamydia are on the rise. There were more than 1.5 million cases reported in the US in 2015, the most recent data available according to the CDC. That's an increase by 6 percent from the previous year. Are you taking the proper steps to protect yourself?


So who gets chlamydia?
Pretty much anyone who has unprotected vaginal, anal, or oral sex with somebody with chlamydia is at risk. But, at least statistically, the risks are greater among young women.

A 2015 STD Surveillance Report found that women are infected with chlamydia twice as often as men, and almost two-thirds of all chlamydia cases were people between the ages of 15 and 24. But then again, those are just reported cases. Men are notorious for ignoring symptoms and avoiding the doctor, so those numbers could be skewed.

How do I spot chlamydia?
The usual genital red flags: A burning sensation when peeing, or a yellow or milky white discharge. Guys might notice pain or swelling in their testicles, but that's only in rare cases. Symptoms can occur anytime between one and three weeks after infection, although in many cases, there aren't any symptoms at all.

Wait, no symptoms? So how the hell do I know if I have it?
By getting annual screenings, even if you don't have symptoms—and especially if you have multiple partners and you're under 25, says Peter Anthony Leone, medical director of the North Carolina HIV/STD Prevention and Control Branch. It's not all that different from how you change the oil in your car. "It's based on either time or miles," Leone says. "So, new partner or once a year—whichever 'comes' first." (Nice, doc.)

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Okay, so how screwed am I if my test comes back positive? Pretty screwed, right?
Not at all. You'll take some antibiotics, stop having sex for seven days or so (let your doctor make that call), and then you're back in the saddle. The only way it'll cause problems in the future is if you don't catch it and treat it.


Untreated chlamydia can give women "an increased risk of potentially heartbreaking consequences, including pelvic inflammatory disease and infertility," says Gail Bolan, the director of the CDC's Division of Sexually Transmitted Disease Prevention. Chlamydia trachomati, the bacteria that causes the disease, can scar or block the fallopian tubes, which leads to becoming the childless aunt who swears she never wanted kids in the first place. There's also evidence that it can promote ovarian cancer.

Well that's grim. How bad is the news for guys?
Actually, until recently, the medical consensus was that chlamydia was just a minor inconvenience for men. It sucked, but the problem went away after awhile. But there's new evidence, like this 2007 study from Spain, that they don't get off scot-free. Men with chlamydia have three times as much DNA fragmentation, which means the strands of sperm DNA are broken and it's more difficult to deliver the DNA to the egg. Their sperm also has 80 percent more physical abnormalities and 10 percent less mobility. Which doesn't mean you'll never be a daddy someday if you've ever had untreated chlamydia, but it's beginning to stack the deck against your conception chances.

The infertile men with chlamydia in the Spain study were given antibiotics, and after just four months their sperm DNA fragmentation improved by 36 percent. And 13 percent of those previously infertile guys managed to get their partners pregnant. Again, these are just numbers, and there are no guarantees for or against any outcome. But it's certainly an argument for antibiotics.

Okay, but if you've had chlamydia once, are you at least immune to catching it again?
You're thinking of chicken pox. You can absolutely get chlamydia a second time, Bolan says, and repeat infection is very common. "As many as one in four young women treated for chlamydia become infected again within a year. This is usually because her partner is also infected, but doesn't receive appropriate treatment," he says.

Yes, you read that correctly. People are getting chlamydia repeatedly because they keep having sex with the person who gave them chlamydia. There are several ways to make sure this doesn't happen. If you get infected, make sure your partner knows and gets tested. If he or she declines this opportunity, or insists that they're "just fine," well, it may be time to remember that old proverb, "Fool me once, shame on you; fool me twice, shame on me."

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