Silent STIs:
Chlamydia and Gonorrhea

The compassionate gynecologists at All About Women discuss two common and dangerous sexually transmitted infections (STIs).

You might think that if you had a sexually transmitted infection you would know, but the fact is that some STIs are usually asymptomatic in women. Two of these silent STIs are chlamydia and gonorrhea. Depending on your age and risk factors, your gynecologist may screen you for both of these STIs at your annual checkup. That's because if you do have one of these infections and it's left untreated, it can cause infertility later on.

Read on to learn more about why you should take chlamydia and gonorrhea screening seriously.

About Chlamydia and Gonorrhea

Chlamydia and gonorrhea are both sexually transmitted infections that are caused by bacteria. They are spread through sex with an infected person, including vaginal, anal, and oral sex. A man can spread chlamydia or gonorrhea to his sex partner even if he doesn't ejaculate.

The Centers for Disease Control and Prevention (CDC) estimates that there are 2.86 million cases of chlamydia in the US each year, and over half a million cases of gonorrhea. Both of these STIs are most common in women between the ages of 15 and 25. You are more at risk for these STIs if:

  • You are under the age of 25 and sexually active
  • You have a new sex partner
  • You have multiple sex partners
  • You don't use a male condom correctly when having sex

Signs of Chlamydia and Gonorrhea

The American College of Obstetricians and Gynecologists (ACOG) notes that most women who have chlamydia or gonorrhea will have no signs. Those women who do have signs may mistake them for a UTI or vaginal infection because they are so mild. These signs might include one or more of the following:

  • Painful or frequent urination
  • Vaginal bleeding or spotting between periods
  • Yellow vaginal discharge
  • Rectal bleeding or pain

Again, most women will have no symptoms, but if symptoms do occur, they will appear two to three weeks after the time of infection.

Course and Complications

The bacteria of chlamydia or gonorrhea move upward through a woman's reproductive tract, first infecting the cervix before potentially moving on to the uterus, fallopian tubes, and ovaries. These bacteria can also infect the urethra and rectum. If either of these STIs moves past the cervix into the reproductive system, it can cause several complications, including:

  • Pelvic inflammatory disease (PID). PID can cause infertility. Refer to our article on PID to learn more.

  • Ectopic pregnancy. This potentially deadly type of pregnancy occurs when a fertilized egg implants in the fallopian tube rather than the uterus. If not caught early enough, ectopic pregnancies can cause massive bleeding that requires emergency surgery.

In addition to these complications, expectant mothers who have gonorrhea or chlamydia can also spread the STI to their baby during the birth process, which can lead to complications in the newborn. For chlamydia these complications can include:

  • Conjunctivitis
  • Pneumonia
  • The complications of gonorrhea can include:
  • Blindness
  • Joint infection
  • Life-threatening blood infection
  • Chlamydia and gonorrhea can be treated during pregnancy and the ACOG recommends that obstetricians screen all pregnant women for these infections during the first trimester.

Diagnosis and Treatment

Because of the frequency of these STIs and their serious potential complications, both the CDC and the ACOG recommend that all women under the age of 25 be screened at their annual gynecological checkup for both chlamydia and gonorrhea.

Women over the age of 25 who have a new sex partner or who have more than one sex partner should also be screened annually.

Your gynecologist can diagnose chlamydia either through a urine test or through a sample collected by swabbing the cervix, urethra, or rectum.

Both chlamydia and gonorrhea are treated fairly easily through the use of antibiotics. Damage that might already be done by the disease, however, is not reversible. Your gynecologist will encourage you to take the following steps to prevent another case of gonorrhea or chlamydia:

  • Make sure you complete your round of antibiotics

  • Have your sex partner screened and, if positive, also treated. Otherwise you can catch the infection again, and multiple infections increase the likelihood of infertility and ectopic pregnancy.

  • Abstain from sex until both you and your sex partner have completed your antibiotic and are clear of the STI.

  • Come in to be retested for the STI in six months.

While both chlamydia and gonorrhea can cause some serious complications, their treatment is surprisingly easy and effective. Preventive screening at your annual gynecological or well woman checkup can ensure that any infection you may or may not know about is caught and treated quickly in order to preserve your long-term health.

Finding out you have a sexually transmitted infection can be upsetting and embarrassing.

The gynecologists at Gainesville and Lake City's All About Women are available for compassionate care through every stage of a woman's life, including helping you through an STI. If you need to schedule your annual gynecological checkup, are concerned that you may have a STI, or have questions about your sexual health, don't hesitate to make an appointment today.

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