Chlamydia Infection in Females

Overview, Causes, & Risk Factors

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

What is going on in the body?

The organism Chlamydia trachomatis causes chlamydia infection. It infects the cells and causes a number of changes. The organism is usually passed from one partner to another during sexual intercourse. 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 causes and risks of the infection?

The organism that causes a chlamydia infection is usually passed from one partner to another during sexual intercourse. 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 chlamydia 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 oral contraceptives

having sex with a partner who previously has had a sexually transmitted disease

having sex with a male who has a chlamydia infection of the urinary tract

Symptoms & Signs

What are the signs and symptoms of the infection?

Most chlamydia 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 chlamydia infection of the cervix in a female may include the following:

vaginal 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

Chlamydia infections of the throat usually cause a sore throat.

Chlamydia 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

Diagnosis & Tests

How is the infection diagnosed?

The provider may suspect a chlamydia 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 surface of the cervix. A throat culture may be ordered if a chlamydia infection of the throat is suspected.

Prevention & Expectations

What can be done to prevent the infection?

Several safer sex practices can help prevent the spread of chlamydia infection. Male condoms and female condoms provide some protection. 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 disease. 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 smear and pelvic exam.

What are the long-term effects of the infection?

Chlamydia infections in females are strongly associated with the development of cervical dysplasia, or abnormal cells in the cervix, and cancer of the cervix.

It is important to treat chlamydia infections to prevent scarring of the fallopian tubes, which connect the ovaries to the uterus. Severe or untreated chlamydia 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 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.

Treatment & Monitoring

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. Antibiotics used to treat chlamydia infections include azithromycin, doxycycline, ofloxacin, sulfisoxazole, and erythromycin.

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, chlamydia infections do not clear up. This can be due to organisms that are resistant to antibiotics.

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.