How to tell if a woman has chlamydia

Having sex should be fun. It can also be awkward, passionate, weird, and even boring at times. But regardless of what kind of sexy time you’re having, sexually transmitted infections (STIs) should always be on your radar. Here’s why: More than 1 million people worldwide contract one each day, according to the World Health Organization. Chief among them is chlamydia, an STI caused by the bacteria Chlamydia trachomati, which spreads via vaginal, anal, or oral sex.

In 2019 alone nearly 2 million people in the U.S. reported chlamydial infections.1 While any sexually active person is at risk, it is most prevalent people between the ages of 15 and 24, according to the Centers for Disease Control and Prevention (CDC). In fact, the CDC estimates that about 1 in 20 young people assigned female at birth in this age bracket has chlamydia.

Unfortunately, no matter how you identify, the signs of chlamydia can be easy to miss. That’s because most people don’t experience any symptoms (and can even have normal health exams after they contract it), which is why this STI is sometimes labeled a “silent” infection.

Untreated chlamydia | Signs of chlamydia | When to see a doctor | Chlamydia prevention

First, how can untreated chlamydia affect your health?

Untreated chlamydia is especially problematic for people with uteruses, because it can have very serious consequences on reproductive health. For one, it can spread to the uterus and fallopian tubes and cause pelvic inflammatory disease (PID), an infection of the reproductive organs, David Soper, M.D., director of the division of benign ob-gyn and professor of obstetrics and gynecology at the Medical University of South Carolina, tells SELF. When it comes to the numbers, he says the condition affects about 10 to 15% of people assigned female at birth with untreated chlamydia.

Some people who develop PID from chlamydia then go on to develop an even more serious issue called perihepatitis or Fitz-Hugh-Curtis syndrome. While rare, this causes inflammation in the lining of the stomach and tissues surrounding the liver. One tip-off that you do have this condition is upper quadrant pain, Dr. Soper says. (Think pain in the pancreas, right kidney, gallbladder, and the intestines.) It’s often paired with other symptoms like fever or chills.

Infertility is another concern. Both PID and untreated chlamydia can cause permanent scarring in the reproductive organs, blocking sperm and eggs from meeting. In fact, about 25% of infertility cases are due to obstructed fallopian tubes, Meike L. Uhler, M.D., a reproductive endocrinology and infertility specialist at the Fertility Centers of Illinois, tells SELF. In some cases, this can be fixed surgically, but not always.

If pregnancy is on your vision board, you’ll also want to take note of this: Pregnant people with chlamydia are more likely to deliver prematurely, and can pass the infection to their babies, potentially causing an eye infection or pneumonia.

Okay, so now that we’ve talked through some of the scary stuff, we do have good news. Chlamydia itself is extremely treatable, so if you catch it quickly it’s completely curable. The key is knowing you even have it, which (as mentioned above) is tricky because the disease often presents without symptoms.

So, what can you do to outsmart chlamydia? Get tested regularly for STIs—chlamydia testing can easily be done with a urine sample now. What that looks like in practice depends on your specific circumstances. For people with vaginas, the CDC recommends yearly testing if you are under 25 and are sexually active, 25 and older and having sex with multiple partners or a new partner, and if you are pregnant.2

What are the signs of chlamydia?

According to Hilary Reno, M.D., Ph.D., an associate professor of medicine at Washington University in St. Louis, chlamydia symptoms usually start a week after you contract the infection, but really there is no set timeline. Adding to the confusion, when you do get chlamydia symptoms, they can often be mild or reminiscent of other common ailments like a urinary tract infection or a yeast infection, or even another sneaky STI, gonorrhea.

You know your body best, so if you feel like something isn’t quite right, it’s best to see a doctor. “If something has changed, and you know what your sexual activity has been, and you are having symptoms, that is an alert that you better get checked,” James Grifo, M.D, Ph.D., program director at NYU Langone Fertility Center and chief executive physician at Inception Fertility, tells SELF. In the meantime, here are some prominent chlamydia symptoms to be on the lookout for:

1. Abnormal vaginal discharge

If you are experiencing vaginal discharge, that isn’t an immediate cause for concern. Some vaginal discharge is normal as it’s the body’s way of cleansing the vagina and keeping it healthy. Changes in your discharge can also be normal, Dr. Grifo says, like during certain times of the menstrual cycle. For example, typically vaginal discharge is clear or milky, but “mid-cycle you often have a runny more mucus-y kind of discharge.” That’s why he says it is important to really know your body.

Now, changes outside of what is normal for your body—vaginal discharge color, smell, and feel—could signal a larger issue. And there are a lot of things that can account for this outside of chlamydia, according to the Cleveland Clinic, including a yeast infection, bacterial vaginosis, gonorrhea, and trichomoniasis. If your discharge is smelly or white, yellow, or gray in color, though, that may be chlamydia.

2. A burning sensation when you pee—and an urgency to go

Nobody likes to feel burning when they pee, but if a chlamydia infection is in the urethra—the tube that moves urine out of your body—it can cause just that or actual pain when you pee, as well as cloudy urine. You may also feel like you need to go to the bathroom often and urgently. Unfortunately, these are also classic UTI symptoms and can easily be confused for one.

3. Rectal pain, discharge, or bleeding

Chlamydia can infect the rectum—the last portion of your large intestine before the anus— either directly through anal sex, or possibly via spread from the cervix and vagina, Dr. Soper says. Chlamydia in the rectum can cause pain, discharge, and bleeding. These are also common symptoms of proctitis, which is seen in folks who have an inflammatory bowel disease like Crohn’s disease or ulcerative colitis. Regardless, these uncomfortable symptoms are not normal, and you should get checked out ASAP to figure out what’s going on.

4. Lower abdominal pain

Obviously, abdominal pain can be caused by a number of things, not just STIs. But when chlamydia is involved, it typically only occurs if the infection has been left untreated for a while, leading to PID, per the U.S. National Library of Medicine. Other symptoms you might experience at this stage are nausea, fever, and pain during sex, but we’ll get to that next.

5. Painful sex and bleeding afterward

If having sex has gone from pleasurable to downright agonizing, it’s not something you should ignore. Chlamydia can cause cervicitis, or inflammation of the cervix, according to Johns Hopkins Medicine, making it extra sensitive during penetrative sex. Bleeding after sex is also a possibility. If the infection spreads and causes PID, that can also make sex feel painful.

6. Pain in the testicles

For people with penises, the majority of whom are asymptomatic with chlamydia, testicular pain can be an indication of a severe case of the STI, Dr. Grifo says. Swelling and tenderness may crop up too. Another thing to watch out for is epididymitis, which happens when the epididymis, the coiled tube that brings sperm to the outside world, becomes inflamed—in this case due to a chlamydia infection, according to the Mayo Clinic.

As with many symptoms we’ve discussed, these could also be signs of a range of other health issues, including gonorrhea, mumps, urine flowing backward into the epididymis, or a groin injury, among others.

7. Reactive arthritis

Like regular arthritis, the reactive kind is also characterized by swelling and joint pain. The difference? The latter is triggered by an infection in another part of the body, according to the Mayo Clinic. Chlamydia isn’t the only infection that can trigger this type of arthritis, but it is one of the most common ones. Dr. Soper says reactive arthritis sometimes presents as a triad of symptoms: joint pain, urinary issues—like discomfort and increased urgency—and eye inflammation, which is characterized by eye redness and pain.

8. Eye inflammation

Speaking of eye symptoms, unfortunately, chlamydia isn’t relegated to the lower half of your body. That’s because an exchange of fluids isn’t the only way it’s transmitted. Skin-to-skin contact can also be the culprit. For example, Dr. Reno says that if you touch an infected area, skip washing your hands, and then touch, say, your eye, you could potentially get chlamydial conjunctivitis, another way to say red, itchy, swollen eyes.

Chlamydia eye symptoms are similar to pink eye. The full list includes eye discharge, redness, itchiness, and sensitivity to light, and usually develops slowly in adults, according to Tufts Medical Center.

We assume avoiding eye chlamydia is high on your list of things to do, so you’ll want to make sure you aren’t sharing washcloths, towels, cosmetics, or even false eyelashes with other people. Hand washing is also a generally good thing to do to keep your overall health in good shape.

9. Sore throat

Yes, you can add chlamydia to the long list of possibilities of why you’ve got a sore throat. That is, of course, only if you’ve recently had oral sex with someone that has a chlamydia infection.

On a positive note, you will likely only end up with a sore throat. “The cells that chlamydia like to infect are not really found in the throat,” Dr. Reno says. “So chlamydia does not seem to cause long-lasting infections in the throat.” She also says that the CDC does not recommend screening for chlamydia in the throat for that reason.

When should you see a doctor about chlamydia symptoms?

There are a few reasons it’s a good idea to see your doctor for STI screening. Dr. Soper says if you have had a high-risk exposure, had unprotected sex with multiple partners, or had sex with someone who has had multiple partners, it’s best to rule out any infections. “Seek out screening even before symptoms occur since so much of chlamydia infection is asymptomatic,” he says.

If it turns out you do have chlamydia, know that it is easily treatable with either a single dose or a seven-day course of antibiotics, according to the CDC. “Unlike, say, herpes, which is a virus and can live in your nerve roots and reappear, chlamydia doesn’t do that, but it can be present for a long period of time,” Dr. Soper says. “If you treat it effectively, it doesn’t come back unless you get exposed again.” And don’t forget to inform your partner(s) if you’ve been infected. After all, wouldn’t you want your partner to let you know? It’s the responsible thing to do.

It’s also a good idea to get retested in three months, Dr. Reno says, as you are at an increased risk of another STI. But not for the reasons you might think. Chlamydia doesn’t actually make you more prone to getting another STI, Dr. Grifo says, but rather the person or people you’re having sex with could have multiple exposures to STIs that then put you at risk, including someone you may think is monogamous. 

How can I protect myself and prevent chlamydia?

Sex is a normal and healthy part of life, and STIs are unfortunately a third wheel that you may have to deal with from time to time. Thankfully, there are ways to reduce your risk of contracting sexually transmitted infections like chlamydia—namely by using condoms and dental dams whenever you get intimate. Talk with your doctor if you’re concerned that you may have been exposed to an STI, or if you’d like to get tested just to be sure. (Remember, the signs of chlamydia in women and men can be hard to spot.)

And don’t feel embarrassed or guilty if you do have chlamydia. “There is a sense of shame around sexually transmitted diseases,” Dr. Grifo says. “Well, what’s the shame? You had sex. People have sex all the time.” You treat it and move on with your life.

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