Chlamydia / Gonorrhea

Chlamydia / Gonorrhea

According to the Centers for Disease Control (1993) there are 12 million cases of sexually transmitted disease (STD) cases reported annually. One quarter of those afflicted are teens.

Chlamydia is a particularly dangerous sexually transmitted disease because 75% of women and 25% of men do not have any symptoms. The bacteria is transmitted during vaginal, oral or anal sexual contact with an infected partner and is the most reported bacterial infection in the United States and the most common bacterial (and thus curable) sexually transmitted disease by far, ahead of gonorrhea and syphilis.

The sexually transmitted disease chlamydia usually comes with no telltale symptoms, so most people don't even know when they are infected. But left untreated, the so-called "silent epidemic" of chlamydia threatens to cause reproductive damage and infertility in many of the 3 million to 4 million Americans who get it each year. "Chlamydia's consequences can be devastating," says Diane Mitchell, M.D., an obstetrician-gynecologist and medical reviewer with the Food and Drug Administration.

Without treatment, the national Centers for Disease Control and Prevention estimates, chlamydia can lead, in up to 40 percent of cases, to pelvic inflammatory disease, a serious infection of the woman's fallopian tubes that can also damage the ovaries and uterus PID can cause scarring and permanent damage to the pelvic organs. Over one in twelve women are left infertile after a first episode of PID, one in five are infertile after a second episode, and 40% are left sterile after three or more episodes of PID.

PID is medically serious. It causes fever and severe pelvic pain. Treatment often requires hospitalization and may leave the woman with impaired fertility. In some cases, PID is fatal.

Pelvic inflammatory disease is caused when the C. trachomatis bacteria move from the cervix (where they enter during sexual intercourse) to the uterus and fallopian tubes, in some cases scarring the tubes enough to make fertilization impossible. "These women may never be able to have children," says Penny Hitchcock, an expert in sexually transmitted diseases, "unless the problem can be surgically corrected, which is uncommon and expensive."

Even if the fallopian tubes are not completely blocked, scarring can interfere with the passage of the fertilized egg into the uterus. Tubal scarring increases the likelihood of an ectopic pregnancy (tubal pregnancy). A blocked egg may instead implant in the fallopian tube, creating an ectopic or tubal pregnancy, which endangers the mother's life and results in the loss of the fetus.

Symptoms of chlamydia, when they occur, usually appear within one to three weeks of exposure. In women, signs can include unusual vaginal discharge or bleeding, burning during urination, or lower abdominal pain. Men, like women, may have pain during urination, or they may notice a burning and itching around or discharge from the penis or pain and swelling in the testicles. More often, though, chlamydia lives up to its reputation for silence.

Also, women infected with chlamydia may have three to five times the risk of getting infected with HIV if exposed, according to CDC. Chlamydia infection is often found in conjunction with gonorrhea. People who are diagnosed with gonorrhea should also be evaluated for chlamydia infection.

It's not known whether chlamydia infection causes fertility problems or other long-term consequences in men. "We are worried--though we don't have a lot of evidence--that chlamydia infection could cause chronic problems in men," Hitchcock says. "But as far as we know, the biggest price is paid by young women."

Babies sometimes pay a price, as well. Babies who are exposed to chlamydia in the birth canal during delivery can be born with pneumonia or an eye infection called conjunctivitis, both of which can be dangerous unless treated early with antibiotics. If a woman is infected with chlamydia while pregnant, the infection can cause premature labor and delivery.

Because so many people are at risk for chlamydia and because the disease can ravage a woman's reproductive system without so much as a symptom, experts recommend regular, widespread screening to detect the disease. Traditional methods of screening require a health professional to collect a swab sample of genital secretions. For women this type of test minutely prolongs a pap smear, At worst, it can feel like a tiny menstrual cramp, but most women don't experience any discomfort. Male samples are obtained by inserting a swab into the end of the penis.


Gonorrhea has plagued millions of people from the earliest times. But what was once known as a fatal disease is now fully curable with antibiotics and proper medical treatment.

A bacterial infection that is usually spread through sexual contact, gonorrhea affects the reproductive tissue in both men and women. Untreated, it can spread to the circulatory system and infect the heart, liver, joints, tendons, and other vital organs. Symptoms include burning and itching during urination, and a thick, yellowish fluid from the penis or vagina. But since women are less likely to show immediate symptoms than men, a doctor should check sexual partners if either has any of the signs of gonorrhea. Sometimes there are no symptoms -- so if you have been exposed to gonorrhea but see no signs of it, it is still critical to get tested.

While the number of people with gonorrhea has been dropping since 1975, more than 800,000 new cases of gonorrhea still occur every year in the United States. You can prevent gonorrhea by adopting safer-sex practices, such as regularly using latex condoms and refraining from oral and anal sex unless you're confident that your partner is not infected. Also, you should not share personal items such as douche equipment.

This sexually transmitted bacteria is passed between partners during oral, anal, or genital sexual contact. The bacteria thrive in the delicate, moist tissue found in the reproductive tract and genitals. They can also live in the throat, rectum, joints, or eyes. Symptoms are generally easier to notice in men than in women. In men, the first symptoms usually appear two to seven days after infection. Mild discomfort in the urethra (which carries urine and semen through the penis) is followed in a few hours by mild to severe pain during urination and a flow of pus from the penis. Frequent, urgent needs to urinate gradually get stronger. The opening of the penis may become red and swollen.

In women, symptoms may first appear within seven to 21 days after infection. But weeks or months can pass with no sign of infection. Often doctors discover the disease in women only after diagnosing her male partner. The symptoms for women are usually mild, but they can become severe: pain during urination, frequent need to urinate, vaginal discharge, and fever. Women may notice pelvic pain and tenderness during intercourse because of infections in the cervix, uterus, fallopian tubes, ovaries, urethra, and rectum. The cervix, urethra, or glands near the vaginal opening may be the source of pus discharged from the vagina. A skin rash is another symptom.

While oral antibiotics such as penicillin and tetracycline used to be standard treatments for gonorrhea, some types of gonorrhea are now growing resistant to these drugs. To overcome this, doctors now prescribe for most people both an oral antibiotic and a potent injectable antibiotic, such as Rocephin (ceftriaxone). This combination will usually cure gonorrhea.

If you have symptoms of gonorrhea, it is critical that you abstain from sexual activity until you are tested and cured. If you are exposed to gonorrhea but don't have any symptoms, it is still vital that you get checked for the disease. Gonorrhea symptoms may take a while to become noticeable, but during that time the disease can progress and you can spread it to others. Because women often have no symptoms of a gonorrhea infection, it is especially important to know your sexual partner's history and to get checked if you see any signs of gonorrhea infection.

If you do not get treatment, the disease may cause pelvic inflammatory disease (see chlamydia), which can infect internal reproductive organs and cause infertility; gonococcal arthritis; and infections of the heart, liver, tendons, joints and other vital organs. In men, it can cause sterility.

If you have gonorrhea, you may also be infected with chlamydia, which is often difficult to detect. When you are tested for gonorrhea, your doctor should also check for chlamydia and potentially treat you on the assumption you have it, too.

Gonorrhea has reached epidemic proportions in the United States. Most new infections occur in people ages 18 to 30, but the disease may affect anyone who engages in sexual activity with an infected person. Infants are at high risk of being born with a severe eye infection (gonococcal conjunctivitis) if the mother is infected. Males and females are both affected, but symptoms are usually more noticeable in males.

For More Information about STDîs, contact:

CDC's National STD Hotline: 1-800-227-8922
NIH's National Institute of Allergy and Infectious Diseases

NIAID Office of Communications
31 Center Drive (MSC-2520)
Building 31
Room 7A50
Bethesda, MD 20892-2520

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