Chlamydia – what you need to know plus the risks for women

28th February, 2023 • 11 min read

Chlamydia can be a ‘silent’ sexually transmitted disease (STD) with no symptoms in most women – but it can lead to fertility problems and pelvic pain. So how do you know you’re infected, plus how do you prevent and treat it?

Why women need to fight back against chlamydia

Chlamydia is the most common STD in the US, with 1.5 million cases diagnosed every year. Yet between 70% and 90% of women who catch it have no symptoms so they don’t even know they’ve been infected.

“Just because most women don’t get symptoms, that doesn’t mean you can ignore it. Chlamydia can cause long term health problems for women including fertility issues and chronic pain if you don’t get it diagnosed and treated with antibiotics. Meanwhile, men are less likely to have serious long term health issues from chlamydia,” says Healthily expert, Dr Ann Nainan.

Here’s why getting tested is so important, particularly if you’re under 25 or you’re in an at-risk group.

Long term effects of chlamydia in women

Without treatment, chlamydia can cause serious health problems. Here’s how:

  • chlamydia can cause inflammation and in up to 30% of untreated cases, it can lead to pelvic inflammatory disease (PID)

  • PID can cause scarring in your fallopian tubes, uterus and the areas around them which, in turn, can cause chronic pelvic pain and make it more difficult for you to get pregnant

  • damage to your fallopian tubes can also lead to a higher chance of ectopic pregnancy

  • untreated chlamydia in pregnancy can cause serious complications such as miscarriage or premature birth

  • if you’re pregnant you can also sometimes pass chlamydia onto your baby during childbirth which can cause conjunctivitis and pneumonia in your baby

Health issues for men and women

  • men and women with chlamydia can develop reactive arthritis (also called Reiter’s Syndrome) – but this isn’t common

  • untreated chlamydia can also increase the chances of men and women catching or passing on HIV

  • long term issues are often less serious in men, but they can include inflammation in the testicles and, rarely, infertility

Video: How to cut your risk of catching chlamydia

What is chlamydia and how do you catch it?

Chlamydia is a sexually transmitted disease (STD) or sexually transmitted infection (STI), caused by bacteria that spreads when you have sex. Here’s what you need to know:

  • women and men can catch chlamydia

  • it can infect your reproductive organs – at first, the bacteria infects your cervix (the entrance to your uterus from your vagina) but it may then spread to your uterus and fallopian tubes

  • you can get chlamydia through having vaginal, oral or anal sex, without a condom

  • you can also catch it before you put on a condom – for example, if your genitals come into contact with your partner’s genitals

Can you get chlamydia without having sex?

“To become infected you need to have intimate sexual contact,” says Dr Ann. “But it doesn’t have to be penetrative sex – you can also get chlamydia if your genitals come into contact with your partner's genitals. For example, a man doesn’t have to ejaculate to pass on the infection because the bacteria can be in his pre-ejaculate (the small amount of fluid that comes out of his penis when he’s turned on).”

You might be wondering, can you get chlamydia from kissing or toilet seats? You can’t pick up chlamydia from an object like a toilet seat or a towel or from a swimming pool or by hugging or kissing.

Who’s at risk of chlamydia?

If you’re sexually active you may be at risk of chlamydia. That’s true even if you’re in an exclusive relationship right now, as you may have picked up an infection before and infected your current partner without knowing – and the same could be true for them.

Higher risk groups

There are a number of reasons why you might be more at risk of catching chlamydia:

  • you’re a woman – In the US, chlamydia cases are higher in women than in men. Figures from 1 study estimated there were 1.3 million women and 1 million men with chlamydia in the US in 2018. It’s partly down to a woman’s vagina being more vulnerable to infection than a penis. Find out more about why STDs are more likely to take hold in women than in men

  • you’re under 25 – 2 thirds of new chlamydia cases are in the 15 to 24 age group. It’s thought that 1 in 20 sexually-active women aged 14 to 24 has chlamydia

  • you have a new or multiple partners – your risk of catching chlamydia is higher if you have a new sexual partner or more than 1 sexual partner

  • you’ve had chlamydia before and have sex with a partner who wasn’t treated for the infection – so you become reinfected

  • you’re a man who has sex with men (MSM)

Chlamydia symptoms

What makes chlamydia so difficult to diagnose and treat is that most women who have it don’t notice any symptoms. “Between 70% and 90% of women don’t get symptoms, which means that only 30% to 10% do get symptoms – and that means you can have chlamydia without realizing it,” says Dr Ann.

Find out when and how to get tested if you think you might be at risk.

If you do get chlamydia symptoms

they can be different in men and women
they usually arrive between 1 and 3 weeks after having unprotected sex with an infected person
some people don’t get symptoms until many months later

Chlamydia symptoms in women who get them

These can include:

Chlamydia symptoms in men who get them

Up to 70% of men with chlamydia also have no symptoms, but when they do they can include:

  • burning or pain when you pee

  • pain/tenderness in your testicles

  • discharge from your penis

  • swelling in your scrotum

Chlamydia infections in your bottom, eyes, and throat

  • women and men can also develop chlamydia in their bottom or anus, which often causes no symptoms or rectal pain

  • you can get conjunctivitis symptoms in your eye if it comes into contact with body fluids infected with chlamydia

  • chlamydia can also affect your throat if you have oral sex without a condom, but this doesn’t usually cause symptoms

Watch this video from an expert at the University of Virginia, US, for more information on chlamydia and its symptoms.

If you’re not sure whether to see a doctor, use our Healthily Smart Symptom Checker to work out your best next steps.


Smart Symptom Checker

What’s it like to have chlamydia?

Catching chlamydia isn’t like announcing you’ve caught a cold. There’s still some stigma attached to it, as people know you’ve had sex to get infected – and there can be a suggestion you might be having casual sex.

“The truth is you could be in a monogamous relationship but have been infected months or years ago and just not realized – it only takes 1 infected partner,” says Dr Ann.

“Be reassured that your doctor will have been trained on STDs including chlamydia and they won’t judge you. Don’t let embarrassment or fear put you off getting a test. You can even buy a test online or at a pharmacy.”

What real women say about having chlamydia

“I was diagnosed with chlamydia after a routine test”

Psychologist and journalist, Shan Boodram, shares how she found out she had chlamydia while she was in a committed relationship:

“My mom is a nurse and she offered me a free health assessment at her job. I had no reason to think anything was wrong with me, but 2 weeks later I got a call to say I had tested positive for chlamydia.

“I had a thousand questions… that’s when I found out that my monogamous relationship was anything but.”

Shan describes herself as a chlamydia survivor – not like chlamydia is life-threatening “but I’m a survivor of the stigma and shame.”

For more experiences of real women who have had STDs read our article, What it feels like to have an STD.

Does chlamydia go away?

  • chlamydia infections can be cleared with antibiotics. You usually take 1 dose of antibiotics or a 7-day course

  • if you don’t get treated, the infection can stay in your body a lot longer. A review of studies of untreated chlamydia cases found the infection stayed in the body for weeks/months in 56% to 89% of cases, and for at least 1 year in between 46% and 57% of people

  • researchers in 1 study estimated that where chlamydia infections become established, it takes men an average of 2.84 years to clear the infection and 1.35 years for women

When to see a doctor

You should see your doctor or go to a sexual health clinic for a chlamydia test if:

  • you have any chlamydia symptoms
  • you’ve had unprotected sex
  • you’ve had treatment for chlamydia but you still have symptoms

You should also see a doctor if you:

  • have severe symptoms like abdominal pain, fever or you feel unwell – you may have PID
  • have joint pain and eye symptoms. These are symptoms of reactive arthritis

It’s also a good idea to have regular STD testing if you have new or multiple partners.

Your doctor may also recommend a test for STDs, including gonorrhea, if you test positive for chlamydia.

Chlamydia tests

You can have a chlamydia test in your doctor’s office or an STD clinic. You’ll have a swab of fluid taken from:

  • your vagina or cervix in women
  • your urethra (pee tube) in men
  • your bottom in both sexes

You’ll usually get your results within 24 hours.

You can also take a vaginal swab yourself with a self test swab kit, which is then sent off for testing.

What about self test kits?

You can buy chlamydia self test kits from pharmacies and online, but if you test positive you’ll need prescription-only antibiotics.

Chlamydia medication

“People often ask ‘is chlamydia curable’?,” says Dr Ann. “My answer is yes definitely, if treated early enough with antibiotics. Early treatment tackles the infection and can prevent long term complications such as PID.”

Chlamydia antibiotics

Treatment for chlamydia is simple: a course of antibiotics and then avoiding sex for 7 days. Antibiotics you might be prescribed are:

  • doxycycline: this is given as pills to to be taken twice a day for 7 days. It’s not suitable for pregnant women

  • azithromycin: taken as a one-off pill treatment, it’s safe to use in pregnancy

If you have complications from chlamydia, your doctor will advise you on the best treatment for you.

Treating partners

If you’ve been diagnosed with chlamydia, any partner you’ve had sex with in the last 60 days, or the last person you slept with, will need to be treated, too.

You should avoid sex for 7 days after your treatment is finished as you could reinfect each other – this happens a lot.

  • in the US you’ll usually have a follow-up test 3 months later to check the infection is gone
  • in the UK , this isn’t always done, but it’s usually done if you’re at risk of getting chlamydia again

Watch this Planned Parenthood video for advice on How to tell a partner you have an STD

One to watch

Scientists are working on a chlamydia vaccine to protect people against the infection. In a study by Imperial College London, researchers found a vaccine was safe and effective at provoking an immune response against chlamydia. More research is needed, but a vaccine could help break the cycle of repeated infection.

Medical disclaimer: Quotes are the views of the authors of these statements and are not necessarily the views of Healthily, its medical team or its writers.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.