What Are the Signs and Symptoms of Chlamydia?

Chlamydia is often called the “silent infection” because most people don’t experience symptoms. About 75% of women and 50% of men with chlamydia have no noticeable signs. When symptoms do occur, they may take weeks to appear after exposure.

“Many people who have chlamydia aren’t aware they have it, so they don’t know they may be infecting their sexual partners,” says Cynthia Wilson, DO, a family medicine physician at Scripps Coastal Medical Center Carlsbad. “Often, women don’t find out they are infected until they have a gynecologic exam that tests for it.”

If symptoms do appear, they may vary by sex.

Chlamydia symptoms in women:

• Abnormal vaginal discharge
• Vaginal itching or burning
• Bleeding between periods
• Painful periods
• Abdominal pain with fever
• Pain during urination or sex

 Chlamydia symptoms in men:

• Clear or cloudy discharge from the penis
• Burning and itching at the tip of the penis
• Pain and swelling around the testicles
• Pain during urination

If the infection spreads to the rectum, people of any gender experience rectal pain, bleeding or discharge.

Untreated chlamydia can cause lasting damage to reproductive and overall health.

Health risks for women:

In women, chlamydia can spread to the uterus and fallopian tubes. This can lead to pelvic inflammatory disease (PID), a painful condition that increases the risk of:

• Infertility
• Ectopic pregnancy (when a fertilized egg implants outside the uterus)
• Chronic pelvic pain
• Miscarriage or preterm birth during pregnancy

Health risk for men:

In men, untreated chlamydia can harm the urethra, which is the tube that carries urine out. It can also affect the epididymis (the coiled tube that stores and carries sperm). This may lead to:

• Painful urination
• Testicular pain or swelling
• Possible fertility issues in rare cases

Risks during pregnancy:

•  Premature birth/ectopic pregnancy
• Low-birth baby
• Newborn eye infections
• Infant pneumonia

Other serious risks: Chlamydia can raise the risk of getting or spreading HIV. This happens because it causes inflammation and tissue damage, which can make transmission easier.

Testing for chlamydia is easy and accurate. Most tests use a urine sample or a genital swab. Pregnant women usually get tested during their first prenatal visit. They are tested again in the third trimester to avoid complications.

If you think you might be at risk, talk to your doctor about testing. Many clinics now offer at-home STI test kits that let you check for chlamydia, gonorrhea, HIV and other infections from home.

At home kits are available at major pharmacies or online from trusted services. Most include discreet packaging and easy instructions. Depending on the test, you may need to collect a urine sample, a vaginal, throat or rectal swab, or a finger-prick blood sample and send it to a certified lab. Results are typically ready within two to five business days.

These tests are highly reliable when used correctly and processed by certified labs. Follow the instructions carefully and test at the right time after exposure for the most accurate results.

If you test positive, many services offer follow-up care, such as virtual consults, prescriptions and treatment guidance. It is also important to notify your sexual partners so they can get tested and treated too.

Chlamydia will not go away on its own and should be treated to prevent serious health problems. It requires antibiotics to fully clear the infection.

The most common treatments are:

• A single dose of azithromycin
• A weeklong course of doxycycline

You must complete the full course of treatment, even if your symptoms go away early. Avoid sex until you’ve finished your antibiotics and your doctor clears you — usually seven days after starting treatment.

While antibiotics can treat chlamydia, they cannot reverse damage already done to your reproductive system. They also won’t prevent future infections. Reinfection is common if your partner hasn’t been treated or if you have sex with a new infected partner.

To protect yourself:

• Use condoms during vaginal, anal or oral sex
• Use dental dams for safer oral sex
• Talk openly with partners about STI testing
• Get tested regularly, especially if you're under 25 or have multiple partners

“We recommend being tested for chlamydia if you have a new sexual partner, or multiple partners. Plan to get tested at least once a year,” says Dr. Wilson. “We also strongly recommend using condoms if you have new or multiple partners to help reduce the chance of infection.”

STI rates in the U.S. are still high. Gonorrhea and syphilis cases have gone down a bit, but chlamydia rates stay high. This is often because it has no symptoms and is often missed in diagnosis.

Public health efforts are making a difference. Routine screening, at-home test kits, and safer sex education are all helpful. “However, we must keep focusing on early detection, treating partners and prevention. This is important to reduce chlamydia and other STI rates over time,” Dr. Wilson says.

“If you are sexually active, especially if you are under 25 or have multiple partners, regular testing is important,” she says. “Using protection is also essential to protect your health and stop the spread of STIs.”