Chlamydia treatment

Chlamydia is the most common sexually transmitted infection (STI) in the UK, especially in people under the age of 25. The infection is not usually serious and can be easily treated with antibiotics, but if left untreated, it can lead to serious complications. It can be easy to miss chlamydia without regular STI testing, because it often causes no symptoms.

Complications from untreated chlamydia infections in women include:

• pelvic inflammatory disease (PID) – an infection of the womb, fallopian tubes, and ovaries, which can lead to a higher risk of ectopic pregnancy (where the baby grows outside of the womb) and infertility
• problems in pregnancy – chlamydia can be passed to a baby during birth, and can make it more likely for a baby to be born early

Complications of untreated chlamydia in men are less common, but include:

• epididymitis or epididymo-orchitis – inflammation and pain in the testicles
• infertility – not being able to have children naturally

Untreated chlamydia can also cause a condition known as reactive arthritis (inflammation of the joints) in both men and women.

How do you get chlamydia?

Chlamydia trachomatis is a bacterial infection and is spread through semen and vaginal fluids, usually during sexual contact. You can get chlamydia through:

• unprotected vaginal, oral, or anal sex
• sharing sex toys without washing or covering with a new condom
• genital-to-genital and skin-to-skin contact if there is sexual fluid present, even without penetration or ejaculation

If you are pregnant and have chlamydia, it can be passed to the baby during childbirth, so it’s important to get tested if you are pregnant and have had unprotected sex.

Chlamydia usually has no symptoms, so most people infected with chlamydia do not know they have it. The most common places that people get chlamydia are in the vagina, penis, or anus (bottom), but you can also get it in the mouth or eyes if sexual fluid comes into contact with these areas.

In people with a vagina, symptoms may include:

• pain or burning when passing urine (peeing)
• unusual discharge from your vagina
• stomach or pelvic pain
• bleeding after sex
• bleeding or spotting between periods
• pain, bleeding, and discharge from your anus, if you have anal chlamydia

Important: Pelvic pain, pain during sex, and unexpected bleeding are also possible symptoms of pelvic inflammatory disorder, a more severe infection. If you have these symptoms, you should see a doctor in person so they can examine you and start treatment as soon as possible.

In people with a penis, symptoms may include:

• pain or burning when passing urine
• unusual discharge from the penis
• pain and swelling in the testicles
• burning and itching around the genital area
• pain, bleeding, and discharge from your anus, if you have anal chlamydia

Chlamydia in the eyes can cause:

• swelling
• redness
• irritation
• pain
• discharge

If you get chlamydia in the mouth, symptoms are not likely, but you may notice a sore throat that does not get better.

Chlamydia is treated with a type of medication called antibiotics that kill bacteria in the body. The 2 antibiotics usually used to treat chlamydia are doxycycline and azithromycin. Sometimes your doctor may prescribe a different antibiotic for you depending on your medical history and general health.

Doxycycline

Doxycycline is the first-choice treatment for chlamydia. It’s also available under the brand names Vibramycin-D, Efracea, and Periostat. Doxycycline works by stopping chlamydia bacteria from making the proteins they need to survive, which kills the bacteria and gets rid of the infection.

How to take it

The usual dose is a single 100mg capsule, twice a day around 12 hours apart, for 7 days. Doxycycline should be swallowed whole with a large glass (at least 150ml) of water, with or after food. It’s also available as dispersible tablets that dissolve in water. It's important to stay upright and not lie down when you take doxycycline and for 30 minutes afterwards. This is to prevent the medication from irritating your oesophagus (food pipe) and stomach.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. However, your doses should be around 12 hours apart. So, if it’s almost time for your next dose, skip the missed dose and take it at the end of your treatment instead, as it’s important to finish all your chlamydia tablets.

How effective is it?

Doxycycline is very effective at treating chlamydia, which is why it’s the first-choice treatment. Studies show that taking doxycycline 100mg twice daily for 7 days is 95% effective. It’s important to take your chlamydia tablets as prescribed and try to avoid missing doses, as this may make it less effective.

Other antibiotic treatments

If doxycycline is not suitable for you, such as if you’re allergic, azithromycin may be prescribed instead. Azithromycin is an antibiotic tablet that also kills the bacteria that cause chlamydia. The usual dose is 1g as a single dose for 1 day, followed by 500mg once a day for 2 days.

Other antibiotics that may be used include:

• erythromycin 500mg twice a day, for 10 to 14 days
• ofloxacin 20mg twice a day for 7 days, or 400mg once a day for 7 days

At Asda Online Doctor, we only prescribe doxycycline for chlamydia. If our doctors think you need a different antibiotic, they’ll let you know.

If you’ve been diagnosed with chlamydia, you need to get treatment. Usually, the clinic where you get tested can also provide chlamydia medication. You can also get tested and get treatment from online services like Asda Online Doctor following a positive chlamydia test result.

You must tell any sexual partners that you have a chlamydia diagnosis, as they need to get tested too. We can prescribe chlamydia treatment for you if you or your sexual partner has a positive result, but your partner will need to request their own treatment.

You should not have sex, including vaginal, anal, or oral sex, even with a condom, until you and your partner have finished treatment. Otherwise, you could pass on the infection again. If you want to tell your sexual partners anonymously, you can do this through a sexual health clinic, or our doctors can do this for you if you get tested using our service.

Sometimes chlamydia medication can cause side effects. Most side effects are not serious, but if you are worried about side effects, or if they do not go away, talk to your doctor or pharmacist.

Common side effects of chlamydia treatment include:

• headaches
• nausea (feeling sick)
• vomiting (being sick)
• photosensitivity (your skin may become more sensitive to sunlight)
• candida infection (thrush) in women

Rarely, serious side effects can occur. These include:

• unexplained bruising or bleeding
• nosebleeds
• fever (high temperature)
• fatigue (feeling tired)
• diarrhoea (may contain blood) and stomach pain
• tinnitus (ringing in the ears)
• yellowing of the skin or the whites of the eyes (jaundice)
• pale coloured poo
• dark coloured pee
• muscle or joint pain
• severe or prolonged headaches
• changes to your vision (eyesight)
• sore throat or pain when swallowing
• indigestion
• swelling of the lips, mouth, and tongue
• separation of your nails from the nail bed (photo-onycholysis)

If you get any of these rare side effects, stop taking your chlamydia medication and speak to a doctor or NHS 111 straight away, or in an emergency, call 999.

Very rarely, the antibiotics used to treat chlamydia can cause a severe allergic reaction called anaphylaxis. Symptoms of anaphylaxis include:

• itchy, red, raised bumps or spots on the skin (hives)
• difficulty breathing
• feeling dizzy or faint
• rapid heartbeat
• swelling of the eyes, tongue, lips, and throat

Anaphylaxis is a medical emergency and can get worse very quickly. You or someone else must call 999 straight away.

Chlamydia treatment is highly effective and cures around 95% of chlamydia infections when taken correctly. You usually do not need to be retested, unless you still have symptoms after finishing your treatment. If you want to take another test to be sure, wait for 6 weeks after you finish your treatment, because the test can stay positive for this amount of time.

Reinfection with chlamydia is common, especially for people under the age of 25. Because of this, it’s recommended that anyone under the age of 25 who tests positive for chlamydia has a repeat test 3 to 6 months after finishing treatment.

As chlamydia can be passed on through sexual contact, the best way to prevent getting chlamydia is to use protection. Condoms are the only type of protection that can prevent STIs, so even if you or your partner are taking something to prevent pregnancy, such as the pill, you still need a condom.

However, even condoms are not 100% effective at preventing chlamydia. The only way to completely prevent chlamydia is to abstain from sexual contact.

Other ways to prevent or reduce the chance of getting chlamydia include:

• using condoms correctly – a condom only works if you use it properly, so make sure you know how to put it on, how to check for signs of wear and tear, and how to check the date on the condom pack to make sure it’s not expired
• using condoms for all types of sex, including vaginal, anal, and oral
• getting regular STI screening – once a year, or sooner if you have new sexual partners, as this can reduce the chances of it spreading without you knowing
• avoiding sharing sex toys – if you want to do this, make sure they’re washed and covered with a fresh condom between users
• limiting your number of sexual partners – you can still get an STI by having 1 sexual partner, but having sex with multiple people, especially if you do not know their STI status, can increase your chances of getting it