You have Chlamydia, to be sure these are three words we never want to hear coming out of the mouth of our doctor. For many this revelation is embarrassing, humiliating, just outright mortifying. You sit there in the doctors exam room wearing that ridiculous paper gown that plays peek-a-boo with all your wrong places. After having been poked and prodded like a rump roast in the meat market you have to bear this unwelcome news.
You feel betrayed by your own good sense, you feel betrayed by your partner, your mentally kicking yourself as you put your clothes on. You leave your doctors office with your antibiotic prescription in one hand and your cell phone in the other, contemplating who to call first, your partner or your best friend. You choose your best friend thinking it might be wise to talk to someone before you confront your partner with this upsetting news. You speed dial your all knowing best friend, the one person in the world you feel comfortable telling the most intimate and private details of your life. Voice mail.............aaauugggghhhhhhhhhh.
You drive home jump on the internet and run Chlamydia through your favorite search engine, you need to know the facts, to seperate a the myths, misinformation and utter bull... uhhh stuff you have heard about this disease. Congrats, you have made to the right place. Read on.
Truth - Chlamydia can be transmitted via the following sexual interactions:
Oral sex: Yes, Chlamydia can be transmitted through unprotected oral sex ( the partner performing oral sex has Oral Chlamydia and transmits it to the partner receiving oral sex) and / or contracted ( the partner receiving oral sex has Genital Chlamydia and the partner giving oral sex contracts or "gets" Chlamydia orally).
Vaginal sex: Chlamydia can be contracted and transmitted through unprotected vaginal sex.
Mythbusting in action: Myth - You can't get Chlamydia just because a condom breaks, your partner has to actually ejaculate (cum) inside you to transmit the bacteria from his penis. That is a myth, if a male partner is infected with Chlamydia the bacteria in all likelihood is present inside the males urethra (pee hole) and is easily transmitted through fluid secretions present in the urethra. He does not have to ejaculate to transmit the disease. If Chlamydia is present during any form unprotected sexual contact (oral, vaginal, anal) the possibility of transmission is high.
Anal sex: Chlamydia can be contracted and transmitted through unprotected anal sex.
Truth - Chlamydia is called the "Silent STD". But Why?
According to the Center For Disease Control (CDC) 75% of women and 50% of men infected with Chlamydia have no symptoms. The CDC in my opinion is the definitive authority for infectious disease they have outstanding resources available on every STD known to man, woman, and ... well you get the picture. However, despite their relative wealth of information and expertise in this field it is a government organization, and as we well know at times government organizations can be found wanting in their efforts to communicate on a more... um how can I put it, human level.
I digress, so why is it that we can have Chlamydia and yet have no symptoms? When we have a cold we usually have symptoms, like a runny nose, sore throat, malaise (big medical word for that tired run down feeling we experience with many illnesses) etc. When we have an in-grown nail that becomes infected we have symptoms. Gesh, you would think that with some thing like an STD we would surely have symptoms, wouldn't we?
Lets think about this for a bit, there are some really obvious reasons women may not exhibit symptoms. One good reason would be that the symptoms (when present) of Chlamydia are very similar to other benign findings in women. The Vagina in its normal state produces fluid secretions similar to those which can be caused by STD's, when a women is on her menses (period) the vagina may produce a higher than normal amount of secretions, and certainly blood. Ultimately vaginal discharge associated with Chlamydial infection my lay anywhere in the spectrum of none existent to profuse, clear to discolored, or any combination of the above.
Additionally, a woman's urethra is located above the vaginal orifice (opening). Being located away from where secretions carrying the bacteria that causes Chlamydia are typically introduced during unprotected vaginal penetration lowers the likelihood that those bacteria will come in contact with the female urethra. Thus decreasing the likelihood that a woman might exhibit the symptoms that would be associated with urethritis (urethritis is a big fancy medical word that simply means inflammation of the urethra). The most common symptoms associated with urethritis are dysuria (yet another fancy medical term meaning painful urination) and urinary frequency (urinating more frequently than one normally would). There are other symptoms associated with urethritis and Chlamydia they can be found (here).
The point is that the female anatomy can inhibit the most common symptom associated with Chlamydia that typically propels us to see our doctor which is painful urination. Dysuria is like a warning siren blaring in your nether regions imploring you to seek medical attention. If dysuria is not present with Chlamydial infection our body is unable to utilize this attention grabbing warning signal to warn us that something may be amiss.
Definitive diagnosis of Chlamydia can be confirmed through laboratory testing. Your health care provider can collect a specimen that can be analyzed for the DNA of Chlamydia. Typically this specimen is collected during a pelvic examination for women or a genital examination for men performed by your health care provider. However, recently tests utilizing a urine specimen that you provide are in use by an increasing number of health care providers. This urine test also utilizes DNA analysis to identify the bacteria that cause Chlamydia. As you might imagine DNA assay testing is far more accurate than tests of the not too distant past.
There are times that your health care provider may choose to treat you with an antibiotic for Chlamydia, based upon your current history of potential exposures to STD's or based upon clinical findings they observe during your pelvic examination. Just because your doctor or health care provider suspects you have Chlamydia (or other STD's), and decides to treat you for Chlamydia does not mean you have Chlamydia. Your providers decision to treat you for Chlamydia though most likely based upon sound medical doctrine and practice does not constitute a reportable diagnosis of Chlamydia. That is, most states require reporting of many infectious diseases, such as Syphilis, TB, Malaria etc. By law "Laboratory" confirmed cases of Chlamydia are considered reportable cases in nearly every state. I will address this in an up coming article.
Causes for one patient being symptomatic (having symptoms) for Chlamydia, and others remaining asymptomatic (big medical word meaning without symptoms) are not well understood. The wide spectrum of symptoms or the lack thereof is the root cause for Chlamydia being labeled the "Silent STD". The diagnosis is frequently made as a presumptive diagnosis, that is your health care provider presumes you have contracted Chlamydia based upon your history of potential exposure and or clinical findings they observe upon examination.
So, did that *&^#$(*!@ give you Chlamydia. Possibly, but the truth may be hard to discern. The many factors to consider are, were you tested for Chlamydia prior to participating in unprotected sexual contact with the partner in question, are you sure you were tested for Chlamydia, frequently women presume that when they are tested for their "Pap smear" they are also tested for STD's that is not always true (topic for upcoming blog entry), has the partner in question been your only partner since your last test for Chlamydia, did you consider that oral sex can also be considered unprotected sexual contact that you could have contracted Chlamydia from another partner who used a condom during vaginal and / or anal penetration but also performed unprotected oral sex on you??? Have you considered that if you have not been tested for Chlamydia and have had unprotected sexual contact with other partners that you could have had Chlamydia pre existing prior to your contact with the partner in question.
As you can see the answer truly is complicated! I would encourage you to ask your health care provider for copies of all of your laboratory tests related to STD's and ask that they explain each finding to your satisfaction. I would also encourage those who are sexually active to get tested annually for Chlamydia, Gonorrhea, Syphilis, Hepatitis, and HIV. Additionally, women would be wise have a PAP Smear accomplished annually as well.
It is an easy thing to blame others for our misfortune, to cast dispersions based upon incomplete information. It is an entirely different thing to look inward at our own behaviors, and to reflect upon and learn from those behaviors. I look forward to any comments you might feel compelled to express regarding this information.
Don't look back....move forward.
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