How do you know if you’re infected?
There may be no warning symptoms of chlamydia and gonorrhoea until the infection is advanced and the inflammation has caused some permanent damage. If there are symptoms, men usually notice them earlier than women, often between two days and two weeks of catching the infection. Silent infection is more common in women than men.
You will usually only know that you’re infected if your partner develops symptoms or if you have swab tests taken by a doctor. It’s important to understand that chlamydia can be present in a woman’s cervix for several years without causing symptoms.
The symptoms in men
In men the most common symptoms are discharge from the urethra or discomfort during or shortly after passing urine. The discharge is often worse first thing in the morning. Gonorrhoea generally causes the most discharge, which is often yellow.
Non-specific urethritis (NSU)
If men develop these symptoms without evidence of gonococci in the discharge, the condition is called non-specific urethritis (NSU)’ or ‘non-gonococcal urethritis’ (NGU). Now that it is easy to test for chlamydia, it can be shown to be the cause of about a third of the infections that would previously have been called NSU. Some of the remainder is caused by ureaplasma. For most others no infectious cause can be found which means that there may be other germs we don’t know about or the symptoms are the result of a previous infection or non-infectious inflammation. If a germ is found to be causing the symptoms, the specific name for the condition (such as ‘chlamydial urethritis’) could be used instead of NSU.
Other symptoms of these infections in males include pain and discharge from the rectum if they practice anal receptive intercourse with other men. If the infection has spread beyond the urethra to the epididymis, pain or swelling around the testes can occur.
The symptoms in women
In women there are often no symptoms until the infection is advanced. Some symptoms might be noticed earlier.
• If the urethra is involved, there may be discomfort on passing urine and an urge to pass urine more often (frequency).
• If the Bartholin’s glands become infected there may be a painful lump near the entrance to the vagina on one or both sides.
• If the infection has spread to the uterus and tubes, there may be abdominal pain, pain on intercourse, lower back pain, bouts of fever or fatigue, heavier periods and perhaps bleeding between periods or after intercourse.
• Occasionally the infection can spread from the tubes into the abdominal cavity to cause an inflammation on the surface of the liver. This is called the Fitz-Hugh-Curtis syndrome, which causes upper abdominal pain, usually on the right side and often made worse on deep breathing or coughing, and sometimes pain in the right shoulder.
Symptoms in both women and men
• If the rectum is infected with gonorrhoea, there may be pain and discharge from the back passage and pain when passing a bowel movement. Chlamydia in the rectum rarely causes symptoms.
• Gonorrhoea can spread into the blood stream to cause fever, skin rash and multiple joint infection with redness pain and swelling, particularly of the
fingers, wrists, elbows, ankles and knees.
• Oral receptive sex can lead to throat infection, which usually causes no symptoms but can be transmitted to a partner during fellatio or cunnilingus.
• Infection transferred to the eye can cause conjunctivitis – severe with gonorrhoea, milder with chlamydia.
• Reiter’s syndrome is a rare, inherited, hypersensitive reaction to chlamydial infection that can cause arthritis, eye problems and recurrent urethritis in both men and women.
*294/31/5*
