Health NW: Chlamydia is not a flower

<center>Kathryn B. Brown, FNP</center>

No, chlamydia is definitely not a flower. Chlamydia (pronounced kla-mid-ee-ah) actually a microorganism (Chlamydia trachomatis) that can infect the male and female reproductive organs. Chlamydia is a sexually transmitted disease.

This disease was rarely diagnosed before the 1980s, when testing methods became readily available. Most people with chlamydia infections have no symptoms at all, so they never get treated.

There are an estimated 3 million cases of chlamydia in the United States each year, making it one of the most common sexually transmitted diseases. It is usually passed when infected semen or vaginal secretions contact the mucous membranes of another person's genitals.

When a woman is infected with chlamydia during sex, the infection can cause inflammation of the cervix, uterus and fallopian tubes within one to three weeks. Usually, this is a silent infection, or one with mild symptoms. However, some women with a severe infection develop pelvic inflammatory disease (PID), with symptoms of pelvic pain, pain during intercourse, fever and sometimes foul-smelling vaginal discharge.

Full-blown PID can cause scarring of the fallopian tubes. These are the narrow tubes between the ovaries and the uterus. If these are blocked due to scar tissue, it is difficult for the eggs released by the ovary to travel to the uterus.

Untreated chlamydia infections that have few or no symptoms are eventually overpowered by the body's immune system, but can also leave fallopian tube scarring that never goes away.

Fallopian tube scarring is a significant cause of infertility, because it interferes with the ability of the male's sperm to reach the female's egg.

The risk of ectopic pregnancy is also increased when there is fallopian tube scarring. In this case, sperm do reach the egg to fertilize it, but the embryo is unable to move down the tube to the uterus to be implanted. Instead, it remains in the fallopian tube. As the embryo grows, the fallopian tube swells and will eventually rupture unless the embryo is removed surgically or treated with a drug called methotrexate. Rupture of the fallopian tubes is a medical emergency requiring surgery, and often causes infertility.

For men, there is some new evidence that chlamydia may harm sperm and cause infertility. The most compelling reason for men to be tested and treated for chlamydia is so they do not pass the disease on to female partners who would definitely be at risk for serious consequences such as PID, ectopic pregnancy and infertility.

Most commonly, testing for chlamydia is done by taking a specimen from the cervix (women) or the urethra (men) with a small cotton swab. There is a newer test done with urine samples.

The treatment for chlamydia is simple: just one dose of an antibiotic called Azithromycin or a seven-day course of Doxycycline is prescribed. It is very important for all sexual contacts to be treated at the same time, and to abstain from sex for a week after completing treatment to make certain that the infection is gone.

The Centers for Disease Control now recommends chlamydia testing at least once a year for:

• sexually active girls and women under age 26

• any woman who has a new sexual partner since her last test

• any woman with multiple sexual partners.

Also, any female with unusual vaginal bleeding, unusual vaginal discharge or discomfort or pain in the pelvic area or lower abdomen should be tested.

Males with any of these symptoms should be tested for chlamydia:

• burning with urination

• the urge to urinate frequently

• clear or white discharge from the penis (usually this is most noticeable first thing in the morning).

Using condoms significantly decreases the chances of transmitting chlamydia, but is not 100 percent effective.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send ideas to kbbrown@eastoregonian.com.

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