Chlamydia is the most commonly found bacterial STI in the Netherlands, and RIVM records tens of thousands of cases each year, mostly in people under 25. The tricky part is that the infection often causes no complaints. So how you feel says little, and only a test gives certainty.
Our stance is simple: with chlamydia, "I notice nothing" is not reassurance but the very reason to get checked. On this page we set out everything in one place.
What is chlamydia?
Chlamydia is an STI caused by the bacterium Chlamydia trachomatis. You can pick it up through unprotected vaginal, anal or oral sex. The bacteria usually settle in the urethra, cervix, anus or throat. Without a test an infection often goes unnoticed, because many people have no complaints at all.
Chlamydia is well treatable with antibiotics. The problem is not the treatment, but the detection.
In the Netherlands chlamydia is found most often each year in people up to around 25, but you can pick it up at any age. RIVM tracks how often the infection occurs via the STI clinics, and those figures have shown the same picture for years: chlamydia is and stays the most commonly found bacterial STI.
What are the symptoms of chlamydia?
Chlamydia often causes few or no complaints. When signs do appear, they usually start 1 to 3 weeks after an infection: a burning feeling when you pee, unusual discharge or pain low in your belly. Those complaints can be mild and fade again, while the bacteria stay.
In a study across five countries (Detels et al., Sexually Transmitted Diseases, 2011) a large share of chlamydia infections turned out to run without symptoms at all. RIVM describes the same picture for the Netherlands. Complaints also differ by site and by person.
The table below shows which signs can belong to which kind of contact. It is a guide to orient yourself, not a diagnosis.
| Where | Possible complaints | Often tested with |
|---|---|---|
| Urethra (women) | Discharge, bleeding between periods, lower-belly pain (often none) | Self-taken vaginal swab or urine |
| Urethra (men) | Discharge from the penis, burning urination, sometimes a painful testicle (often none) | Urine |
| Anus | Usually no complaints, sometimes itching or discharge | Anal swab |
| Throat | Almost never any complaints | Throat swab |
Want more on complaints by sex? Read chlamydia in men and chlamydia in women. If you are unsure about burning when urinating, that also fits a bladder infection.
How do you get checked for chlamydia?
You can get checked via your GP, a sexual-health clinic or a test you take at home and send to a laboratory. For chlamydia the lab usually uses urine or a swab, examined with a sensitive PCR technique. You take the sample yourself and often have your results within a few days.
A test is only reliable after the window period. For chlamydia that is usually from around 2 weeks after a risk contact. If you test earlier, a result can be false negative.
If you want to keep it discreet, you can do an anonymous chlamydia test with us. If you were exposed to several STIs at once, a combined test for chlamydia, gonorrhoea and trichomonas is often more sensible than separate tests. More on the waiting time is in how long after sex you can test for STIs.
How is chlamydia treated?
Chlamydia is well treatable with antibiotics your GP prescribes. In practice doxycycline is often used, and azithromycin in some situations. Which course and dose fits you is decided by your doctor. After a proper course the infection clears in most people.
Research helps underpin that choice. In a randomised study (Geisler et al., New England Journal of Medicine, 2015) cure with doxycycline was slightly higher than with azithromycin. A meta-analysis (Kong et al., Clinical Infectious Diseases, 2014) saw a comparable difference.
What matters during and after the course is in chlamydia treatment with antibiotics. If you got a positive result, a positive STI result: what now helps you further.
What are the risks of untreated chlamydia?
An untreated chlamydia infection can spread further over time. In women that can sometimes lead to inflammation in the abdomen (PID) that may affect fertility. In men it can cause inflammation of the epididymis. Far from everyone develops complications, but catching it early lowers the chance.
The basis comes from clinical research. An analysis of prospective studies (Price et al., American Journal of Epidemiology, 2013) estimated the risk of PID after a chlamydia infection, and a review by Haggerty et al. (Journal of Infectious Diseases, 2010) mapped the possible risks in women.
How this works and how to keep the risk small is in chlamydia risks and infertility. If you are thinking about getting pregnant, also see STIs and trying to conceive.
Chlamydia and your partner(s)
Because chlamydia is so often symptomless, a partner can be infected without either of you noticing. If chlamydia is found in you, it is usual for recent partners to get checked too, regardless of complaints. That breaks the chain in which the bacteria bounce back and forth.
That back and forth is called ping-pong infection. It is the most common reason an infection comes back.
How to raise this calmly is in notifying your partner after a positive STI test. Wait with unprotected sex until you and your partner have finished the course and your GP gives the go-ahead.
How do you prevent a new infection?
You cannot rule it out fully, but you can lower the chance. Consistent condom use reduces the risk considerably, although a condom does not cover every contact. On top of that, a check after treatment can help catch a reinfection early, especially if you were exposed again.
Reinfection happens more often than people think, usually via a partner who was not treated. When a retest makes sense for you is in chlamydia retest and follow-up.
If you want to know which test fits your situation, start with our guide which STI test you need and when. With chlamydia, testing is and stays the only way to get certainty.
How reliable is a chlamydia test?
A chlamydia test using the PCR technique is sensitive and reliable, as long as you test after the window period. PCR detects the genetic material of the bacteria, even when little is present. If you test too early, an infection can still sit below the detection limit and you may get a false-negative result.
For chlamydia the window period is usually around 2 weeks. Some people wait a little longer for extra certainty.
Reliability also depends on the sample. In women a self-taken vaginal swab is often slightly more sensitive than urine. In men a urine sample usually works well, especially if you have not peed for a couple of hours. The lab we use runs the same analysis as a GP laboratory, whether you take your sample at home or at a testing location.
If you want to know exactly how long to wait for your situation, read STI test results: how long do you wait.
Can you have chlamydia in your throat or anus?
Yes, chlamydia can also sit in the throat or anus, depending on the kind of sexual contact. These infections usually cause few or no complaints, so they are easily missed by a test that only looks at urine. A targeted swab at that site can then make sense.
Many people do not know that a routine urine test can miss a throat or anal infection.
If you have had oral or anal sex and want to be sure, discuss with your GP or the GGD whether an extra swab fits you. That way an infection at another site does not stay unnoticed and get passed on unknowingly.
Chlamydia and other STIs
Chlamydia often occurs alongside other STIs, because the route of transmission is the same. If you were exposed, it can sometimes make sense to look wider than chlamydia alone. A combined test can cover chlamydia, gonorrhoea and trichomonas in one go.
Gonorrhoea causes similar complaints and is often mentioned in the same breath. More on that is in gonorrhoea (the clap). The lesser-known STIs are covered in trichomonas and mycoplasma.
Which test fits your situation depends on your complaints and your contacts. If in doubt, a broader check can feel more reassuring than a single test, because you rule out several STIs at once.
Chlamydia during pregnancy
Chlamydia during pregnancy may be passed to the baby during birth, and can then cause an eye or airway infection, for example. Treatment with a safe antibiotic lowers that chance. Doxycycline is not used in pregnancy, so your GP or midwife chooses a suitable alternative.
Many pregnant people notice nothing of an infection themselves, because complaints are often absent.
If you are thinking about getting pregnant or are already pregnant, discuss with your GP or midwife whether a test fits you. More about testing around a wish to conceive is in STIs and trying to conceive.
Frequently asked questions about chlamydia
Does chlamydia clear on its own? Sometimes the body clears the bacteria itself, but you cannot count on that. Without treatment an infection often persists and you can pass it on. So testing and, if needed, treating is the safe route.
Can you get chlamydia without penetration? Transmission mainly runs via mucous-membrane contact during vaginal, anal or oral sex. You do not get chlamydia from just hugging or a toilet seat. We debunk more myths in 5 myths about STIs.
Can you get chlamydia more than once? Yes. A previous infection does not protect you against a new one. With a new risk contact you can get infected again, even after successful treatment.
Does the contraceptive pill protect against chlamydia? No. The pill prevents pregnancy, but offers no protection against STIs. Only a condom lowers the risk of infection.
Will my partner notice my test? No. With us you test anonymously and without insurance, so you keep it fully in your own hands.
How soon do I get my results? Often within a few days after your sample arrives at the lab. Your results sit in a secure online environment only you can open.
Can chlamydia come back after treatment? Yes, usually via a partner who was not treated alongside. How to prevent that is in chlamydia retest and follow-up.
Every STI result we provide is assessed by a BIG-registered doctor. If you have symptoms or are unsure about your situation, discuss it with your GP or the GGD; this article is meant as explanation, not as medical advice.
Sources
- RIVM, Chlamydia
- Thuisarts.nl, I may have chlamydia
- Detels R et al. The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five countries. Sex Transm Dis. 2011 (PMID 22256336).
- Geisler WM et al. Azithromycin versus doxycycline for urogenital Chlamydia trachomatis infection. N Engl J Med. 2015 (PMID 26699167).
- Kong FY et al. Azithromycin versus doxycycline for the treatment of genital chlamydia infection. Clin Infect Dis. 2014 (PMID 24729507).
- Price MJ et al. Risk of pelvic inflammatory disease following Chlamydia trachomatis infection. Am J Epidemiol. 2013 (PMID 23813703).
- Haggerty CL et al. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis. 2010 (PMID 20470050).
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